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The advent of HIV and AIDS has brought about many diagnostic and management challenges regarding multiple opportunistic infections. Pneumocystis jirovecii pneumonia (PCP) is a common presentation in patients with AIDS who are not on prophylaxis or highly active antiretroviral therapy (HAART). Herpes simplex 1 virus (HSV-1) is a ubiquitous virus that mainly causes benign disease during primary infection. However, it is known to cause severe pneumonia and disseminated disease in the immunocompromised.1 We present a case of HSV-1 pneumonitis and PCP co-infection in an HIV-positive patient with respiratory failure. To the best of our knowledge, based on Pubmed and Google Scholar searches, this is the first case to be reported in the English language literature.