Disseminated cytomegalovirus infection occurs predominantly in immunocompromised hosts. Involvement of the gastrointestinal tract in the acquired immunodeficiency syndrome is frequent, but to our knowledge there is only one report of involvement of the appendix. In this study, a patient with a history of the acquired immunodeficiency syndrome who presented with fever and an acute abdomen is described. At surgery, appendicitis was found. In the surgical specimen, appendicitis and cytomegalovirus infection were found. Cytomegalovirus should be considered as a possible cause of appendicitis in the acquired immunodeficiency syndrome.