Anemia in HIV-infected patients is often overshadowed by other disorders associated with this viral disease, but it can markedly contribute to morbidity and limit antiviral therapy. Evaluation of this patient population is difficult because of the probability of a multifactorial etiology and spurious laboratory indicators. Ineffective or reduced erythropoiesis is a hallmark of most anemic HIV-infected patients, leading to usage and continuing research of recombinant hematopoietic cytokine therapy. The continuing explosion in knowledge of this virus, its effects, and treatment possibilities will, hopefully, lead to improved diagnostic and therapeutic options in approaching HIV-associated anemia.