Objective: Head and neck involvement in Kaposi’s Sarcoma (KS) is not unusual . However, laryngeal involvement is a relatively infrequent manifestation and ENT specialists should consider it in differential diagnosis in laryngeal lesions of AIDS patients and/or subjects from the Mediterranean area. Methods: Case report and review of the literature in English Clinical Case: Male patient presenting with a three- month history of cough and acute dispnoea. Laryngoscopy identified a laryngeal mass occluding the glottic plane. Tracheotomy was then performed and the laryngeal lesion was removed. Histopathology showed neoplastic spindle cells that were positive to immunostain with CD-31 and CD-34, and immunoreactivity for HHV-8 was present. A diagnosis of KS was then suspected and confirmed after dermatological inspection. Conclusions: Purple vascular mass lesions should lead in ENT to a high index of suspicion to exclude systemic diseases. Laryngeal KS must be included in the differential diagnosis of pigmented laryngeal lesions to plan correct management