Gastrointestinal complications are an important aspect of the acquired immune deficiency syndrome. In this report we describe two male homosexuals with the acquired immune deficiency syndrome whose gastrointestinal symptoms culminated in the complication of intestinal perforation. Cytomegalovirus inclusions are seen prominently in the areas of perforation. The pathogenic role of cytomegalovirus in these cases is discussed. We propose that cytomegalovirus-induced enteritis may lead to bowel perforation in patients with the acquired immune deficiency syndrome.