The differential diagnosis of neovascular skin lesions in patients with AIDS includes Kaposi’s sarcoma and bacillary angiomatosis. It has been suggested that the radiographic presence of lytic bone lesions in association with these skin lesions supports a diagnosis of bacillary angiomatosis. We present a case of disseminated Kaposi’s sarcoma in which evidence of lytic vertebral disease was seen on computed tomography; the histopathologic characteristics of the osseous lesions are described. Findings of magnetic resonance imaging implied more diffuse marrow involvement. Human immunodeficiency virus-associated osseous manifestations of rochalimaea infection and Kaposi’s sarcoma are reviewed.