Spontaneous aneurysmal regression is a rare event, having been observed only in association with arteritides or immunosuppression following solid-organ transplantation. In particular, the spontaneous regression of an aortic aneurysm, to our knowledge, has never been documented. We report a case of a 46-year-old, HIV-positive, African-American man who developed an asymptomatic juxtarenal abdominal aortic aneurysm, which significantly regressed over a 6-month period in the absence of arteritides or systemic immunosuppressive therapy. This case describes the spontaneous regression of an inflammatory AAA in an HIV-positive patient. Further studies will be required to determine if this was an isolated occurrence or if it occurs with any frequency in specific patient populations.