Endocarditis due to Streptococcus pneumoniae has become uncommon in the penicillin era. Pneumococcal endocarditis most often presents as an ulcerative endocarditis causing rapid destruction of the normal aortic valve, but pulmonic valve involvement is rarely reported. Alcoholism is the most frequent underlying medical condition, and the infection typically follows pneumonia and may additionally be complicated by meningitis (Osler triad).The incidence of invasive pneumococcal disease has recently increased because of the onset of human immunodeficiency virus epidemic. We describe a case of S. pneumoniae endocarditis involving the pulmonic valve in a patient with human immunodeficiency virus infection/acquired immunodeficiency syndrome presenting with multilobar pneumonia and acute respiratory failure. Pertinent literature is reviewed.