The frequency and factors associated with cardiomyopathy were studied among inner-city hospital patients with human immunodeficiency virus (HIV) infection. Of 84 patients with HIV infection, 20 (24%) had cardiomyopathy. Fourteen (70%) of the patients with cardiomyopathy did not have clinical evidence of congestive heart failure. There was no significant association between cardiomyopathy and common opportunistic infections or zidovudine treatment. These results indicate that cardiomyopathy is common in patients with HIV infection and often is clinically unsuspected.