Disseminated adenovirus infection with fatal hepatic necrosis has been reported in 16 patients, 15 of whom had immunocompromising conditions. Herein we report three patients with AIDS and fatally disseminated adenovirus infection with hepatic necrosis. The median age of these 16 patients was 4.7 years, and their illness was characterized by fever (13 of 16 patients), coagulopathy (10 of 16), lower respiratory tract disease (10 of 16), and gastrointestinal hemorrhage (five of 16) in addition to clinical evidence of hepatitis. The adenoviruses isolated were the commonly found serotypes 1, 2, 3, 5, and 7 for 13 of the 15 cases for which this determination was available. With the high frequency of adenovirus infection in humans and the increasing prevalence of human immunodeficiency virus infection in children, it seems likely that this syndrome will continue to be seen.