Neuroimaging technology continues to unfold in a very exciting way, providing almost limitless information about the structural and functional integrity of the nervous system. In patients with an immunocompromised state such as those infected with human immunodeficiency virus (HIV) and subsequently developing acquired immunodeficiency syndrome (AIDS), neurologic complications represent an important manifestation requiring vigilance. Many of the central nervous system (CNS) disorders related to HIV and AIDS are treatable and without prompt diagnosis and treatment, will lead to significant morbidity or death. Neuroimaging plays an increasingly pivotal role in the early diagnosis and longitudinal monitoring of these conditions. The author intends to provide an overview of neuroimaging technology and its applications including various magnetic resonance imaging (MRI) and functional imaging techniques in the evaluation of patients with HIV and AIDS related CNS disorders. The role of neuroimaging in this population includes early detection of direct HIV infection, opportunistic infections, neoplasia, or cerebrovascular diseases. In addition, through a wide breadth of imaging techniques, the pathology, neurochemistry and metabolism of lesions can be studied to clarify the differential diagnosis, such as discriminating infection vs. neoplasia.