Kaposi sarcoma (KS) is one of the most common neoplasms diagnosed in HIV-seropositive subjects. Oral involvement is frequent and is associated with a poor prognosis. The aim of this study was to characterize the features of oral HIV-KS in patients from Ga-Rankuwa, South Africa. Twenty of the 37 patients in the study were females and 17 were males. In 21 patients, the initial presentation of HIV-KS was in the mouth. Other than the fact that females presented with larger (?10mm) oral KS lesions, there were no statistically significant gender differences. Significantly more patients presented with multiple oral HIV-KS lesions than with single lesions. Nine patients developed concomitant facial lymphoedema, and these patients had a significantly lower CD4+ T cell count compared to the rest of the group. The average CD4+ T cell count of the patients who died was significantly lower at the time of oral-KS presentation than of those who survived. In Ga-Rankuwa, South Africa where HIV-KS is prevalent, oral KS affects similarly males and females. A low CD4+ T cell count at the time of oral HIV-KS diagnosis and the development of facial lymphoedema portends a poor prognosis.