Kaposi's sarcoma (KS) remains a mysterious condition over 100 years after its first description. It is a rare cancer-like disease that can appear as a multicentric pigmented 'sarcoma' in elderly men of Jewish or East European origin. KS is often slow-growing and can respond to minimal treatment. However, in advanced cases involving the gastrointestinal and respiratory tracts, it can be life-threatening. KS is classified into four main types: nodular, florid, infiltrative, and lymphadermopathic. A systemic classification similar to Hodgkin's disease has also been proposed. KS is associated with immunosuppression, particularly in patients who have received organ transplants or are HIV-positive. In Africa, KS is endemic and is linked to HIV transmission through heterosexual contact. The role of HIV in KS is complex, as some HIV-positive individuals do not develop KS, while others do. Genetic factors may also play a role, with certain HLA antigens being more common in KS patients. The aetiology of KS is not fully understood, but there is evidence of an infectious component. While HIV is not the direct cause, it may contribute to the development of KS through immunosuppression. Studies have also suggested a possible role for other viruses, including cytomegalovirus and retroviruses. KS cells are of endothelial origin and may be activated by various factors, including growth factors and immune system interactions. The basic biology of KS involves angiogenesis, the formation of new blood vessels, which is a key feature of the disease. KS cells can produce factors that support their own growth and the growth of other cells. The immune system plays a crucial role in KS, with interactions between immune cells and endothelial cells influencing the disease's progression. HIV infection leads to immunosuppression, which may contribute to the development of KS. Treatment of KS depends on its type and whether it is HIV-related. Classical KS responds well to radiotherapy and chemotherapy, while HIV-related KS may require systemic treatment, including anti-HIV therapy and chemotherapy. In conclusion, KS is a complex disease involving a combination of genetic, immunological, and infectious factors. Understanding its basic biology is essential for developing effective treatments. The role of HIV in KS is significant, and eliminating HIV infection may be key to treating KS in HIV-positive patients. Further research is needed to fully understand the pathogenesis of KS and to develop more effective treatments.Kaposi's sarcoma (KS) remains a mysterious condition over 100 years after its first description. It is a rare cancer-like disease that can appear as a multicentric pigmented 'sarcoma' in elderly men of Jewish or East European origin. KS is often slow-growing and can respond to minimal treatment. However, in advanced cases involving the gastrointestinal and respiratory tracts, it can be life-threatening. KS is classified into four main types: nodular, florid, infiltrative, and lymphadermopathic. A systemic classification similar to Hodgkin's disease has also been proposed. KS is associated with immunosuppression, particularly in patients who have received organ transplants or are HIV-positive. In Africa, KS is endemic and is linked to HIV transmission through heterosexual contact. The role of HIV in KS is complex, as some HIV-positive individuals do not develop KS, while others do. Genetic factors may also play a role, with certain HLA antigens being more common in KS patients. The aetiology of KS is not fully understood, but there is evidence of an infectious component. While HIV is not the direct cause, it may contribute to the development of KS through immunosuppression. Studies have also suggested a possible role for other viruses, including cytomegalovirus and retroviruses. KS cells are of endothelial origin and may be activated by various factors, including growth factors and immune system interactions. The basic biology of KS involves angiogenesis, the formation of new blood vessels, which is a key feature of the disease. KS cells can produce factors that support their own growth and the growth of other cells. The immune system plays a crucial role in KS, with interactions between immune cells and endothelial cells influencing the disease's progression. HIV infection leads to immunosuppression, which may contribute to the development of KS. Treatment of KS depends on its type and whether it is HIV-related. Classical KS responds well to radiotherapy and chemotherapy, while HIV-related KS may require systemic treatment, including anti-HIV therapy and chemotherapy. In conclusion, KS is a complex disease involving a combination of genetic, immunological, and infectious factors. Understanding its basic biology is essential for developing effective treatments. The role of HIV in KS is significant, and eliminating HIV infection may be key to treating KS in HIV-positive patients. Further research is needed to fully understand the pathogenesis of KS and to develop more effective treatments.