The spectrum of pulmonary disease in people with human immunodeficiency virus (PWH) across the lifespan has shifted from acute, infectious, and acquired immunodeficiency syndrome (AIDS)-defining illnesses to a greater burden of chronic, non-communicable processes. Here, the authors review the epidemiology and risk factors of pulmonary disease in PWH across the lifespan during the contemporary antiretroviral therapy era. The authors focus on recommendations for clinical care of pulmonary disease relevant to PWH, including emerging data from recent and ongoing clinical trials.