Introduction: Kaposi's Sarcoma (KS) usually manifests as a cutaneous disease but GI mucosal manifestation are often rare. It is associated with human herpes virus-8 infection (HHV-8) and often seen in immune-compromised patients. In the USA, the widespread use of highly active anti-viral therapy (HAART) as drastically reduced the incidence of KS in HIV-infected patients. Here we present a case of oropharyngeal manifestations of Kaposi Sarcoma in a patient with HIV Case Report: A 65 year old male with history of human immunodeficiency virus (HIV) was admitted to the intensive care unit (ICU) after having a cardiopulmonary arriest secondary to hyperkalemia 7.5 meq/L. Following the placement of orogastric and endotracheal tube (ETT), significant amount of blood was noticed in the ETT. Hemoglobin was found to have trended downwards from 9.6 mg/dL to 6.7 mg/dL over the following five days. Stool guaiac was found to be positive for occult blood. Esophagogastroduodenoscopy (EGD) was initially performed and revealed multiple large hyper-vascularized violaceous submucosal nodular lesions with stigmata of recent bleeding seen on the soft palate, pharynx and within the crico-pharyngeal area close to the vocal cords. No active bleeding was noted. Examination of the distal esophagus revealed a severe ulceration with a small hiatal hernia. Biopsy of soft palate lesions showed proliferation of neoplastic spindle shaped cells arranged in bundles with slit-like capillary spaced containing erythrocytes which is consistent with Kaposi sarcoma. Biopsy was also positive for HHV-8. Colonoscopy was unremarkable for similar lesions, polyps or diverticulosis. There were no cutaneous manifestations of the disease. Conclusion: GI involvement of Kaposi sarcoma must be considered in immune-compromised patients and can be confirmed by endoscopic methods.