BACKGROUND. Kaposi's sarcoma (KS) accounts for significant morbidity in AIDS patients. Lesions are often numerous, disfiguring, painful, and may interfere with function. Although generalized therapy is available, local treatment is often more desirable. OBJECTIVE. TO summarize the available data on local therapy for KS. METHODS. Literature was searched using Medline. RESULTS. Excision, laser destruction, cryotherapy, intralesional chemotherapy, immunotherapy, and radiation therapy were compared for success rate, cost, and convenience. CONCLUSION. Intralesional therapy, cryotherapy, and radiation all have substantial advantages over excision or laser surgery. Choice of the appropriate modality varies with different sites and patients.