Primary effusion lymphoma (PEL) is a rare subset of non-Hodgkin’s lymphoma that predominantly grows in body cavities as neoplastic effusions without a contiguous tumor mass. Most PEL cases occur in an immunocompromised state, such as AIDS. We report a case of PEL complicated by not only AIDS but also liver cirrhosis. A 48-year-old man was referred to our hospital because of pleural effusion, ascites and emaciation. Cytologic study and CT revealed the existence of lymphoma cells in the effusion, without mass lesion, leading to a diagnosis of PEL. He was also diagnosed as having AIDS and hepatitis B liver cirrhosis. A large amount of HHV-8 DNA was found in the pleural effusion. Lamivudine and HAART treatment were given for the HBV and HIV infection respectively. Chemotherapies with CHOP, EPOCH, or DeVIC were refractory for PEL, and the patient died of hepatic failure and cerebral hemorrhage. This is the first report of an AIDS patient complicated by PEL and liver cirrhosis.