Infection with Sporothrix schenckii causes a localized lymphocutaneous disease in the immunocompetent host, while it frequently results in disseminated disease in the immunocompromised patient. There are a growing number of reports of S. schenckii infection in the human immunodeficiency virus (HIV)-infected population, where the disease usually starts as a localized cutaneous lesion and subsequently disseminates. The optimal treatment of systemic sporotrichosis in HIV-positive patients is as yet unknown. This article presents a case report of disseminated sporotrichosis in an HIV-infected patient, a review of the literature, and discussion of treatment options for HIV-infected patients.