Thoracic manifestations of HIV positive patients have undergone a gradual metamorphosis due to more awareness about the disease and prolonged longevity of the patients due to better treatment options available now, therefore it is necessary for the radiologist to be aware of changing trends in disease prevalence, epidemiology and the possible pathology. Present study was conducted at Sassoon General Hospital, Pune. Twenty five seropositive patients (ELISA positive) showing signs/ symptoms like fever, cough, breathlessness, hemoptysis, dull note on percussion, lymphadenopathy etc are included in the study. CT sections of thorax were taken at 10mm intervals before and after intravenous contrast administration using spiral mode.We concluded that M. tuberculosis infection was the commonest opportunistic agent in HIV positive patients, however, community acquired bacterial pneumonia was the most frequent cause of pneumonia in HIV infected patients. We concluded that CT is the most important imaging modality used to evaluate chest in HIV positive patients. Contrast enhanced spiral CT is needed to adequately demonstrate lymphadenopathy and HRCT shows distinct advantage in terms of delineation of parenchymal changes.