A 28-year-old white man, positive for HIV, who was admitted to hospital for pneumonia, had for 2 months had several fluctuating cutaneous purple nodules on his legs and abdomen. Cultures of two lesions were negative, but light and electron microscopy showed organisms characteristic of bacillary angiomatosis. The patient responded well to therapy with erythromycin. This is the first reported case of bacillary angiomatosis in South Africa.