Molluscum contagiosum (MC) has arisen as an opportunistic pathogen in human immunodeficiency virus (HIV) disease. Recent reports have focused on the presentation of MC in adults who are HIV positive. The authors describe MC in a pediatric patient with acquired immmune deficiency syndrome. This particular patient showed the same atypical lesion morphology, distribution, and chronic course that is seen in the adult HIV patient. As in the adult patient, treatment in the pediatric patient also remains challenging, with limited success of traditional treatment modalities. The authors were able to achieve long-term remission and an excellent cosmetic result through meticulous superficial surgical excision of the patient's MC lesions.