Introduction: The aim of this study was to define the incidence of classic Kaposi’s sarcoma in Sardinian patients with another synchronous or heterochronous malignancy, and to evaluate the role of classic Kaposi’s sarcoma as a risk factor for cancer. Materials and methods: Data from the cancer registry of Sassari province, including all incident cases of classic Kaposi’s sarcoma, as well as all other types of cancer during an 18 year period (1992–2010) were used for analysis. Results: The European adjusted incidence rates of Kaposi’s sarcoma in North Sardinia was high in both males (2.25/100,000) and females (0.85/100,000). However, a decreasing incidence trend was observed in the period under investigation. Odds ratio between these patients and those with multiple neoplasias other than Kaposi’s sarcoma was 3.40. Conclusions: A high incidence but a decreasing trend of classic Kaposi’s sarcoma was detected in North Sardinia during the period under investigation. Our data suggest that classic Kaposi’s sarcoma may have a role in the development of further malignancies in affected patients.