Kaposi's sarcoma is a multisystem neoplastic disease in which skin manifestations are usually seen first. Visceral involvement is frequent and the gastrointestinal tract is the most common location. We report a patient with Kaposi's sarcoma in whom the typical violaceous skin lesions were the sarcoma in whom the typical violaceous skin lesions were the only overt clinical manifestations, but the patient had multiple macular angiodysplastic-like lesions on colonoscopy. In contrast to the uniform appearance of the colonic lesions, polypoid, volcano, and maculopapular lesions were seen in the stomach on endoscopy. This report provides probably the first endoscopic description of the colonic lesions of Kaposi's sarcoma and contrasts them with the typical upper gastrointestinal lesions. A thorough gastrointestinal survey should be performed in all patients with Kaposi's sarcoma to delineate involvement, since appropriate treatment will be dictated by the presence or absence of visceral involvement.