St. Paul's Hospital, Vancouver has the largest Canadian experience of the care of persons with HIV/AIDS. This article reviews St. Paul's experience during the period 1987-1991, with particular emphasis on issues in palliative AIDS care. These issues include the implications of prolonged palliative care at home, precipitous readmissions to hospital for terminal care, and long-stay terminal admissions. Aspects of treatment and social factors which have an impact on palliative AIDS care are also identified. The implications for program development in both community and institutional settings are discussed.