Human immune deficiency virus (HIV) infection is a multisystem disease with a variety of clinical manifestations in the renal system. In the glomerulus, it causes HIV-associated nephropathy (HIVAN) and immune complex disease whereas in the vascular compartment, it most commonly causes thrombotic microangiopathy. Although rarer, amyloid A (AA) amyloidosis is another entity that can involve all the compartments of the kidney in HIV-infected patients. We are reporting a case of a 35-year-old male, a resident of Atrauli, a daily laborer by occupation with an active naive [HIV + HCV (hepatitis C virus)] infection admitted for the evaluation of nephrotic syndrome. He gave a history of inhalational recreational drug abuse but denied any intravenous (IV) drug abuse. Renal function tests (RFT) of the patient were found to be normal. Based on the history and relevant investigations, there is no evidence of any other chronic infectious or inflammatory disease. The patient has been started on direct-acting antiviral (DAA) therapy for HCV on antiretroviral therapy (ART) for the HIV infection. A renal biopsy has been performed which revealed pale eosinophilic deposition over the mesangial matrix in hematoxylin and eosin (H&E) stain with Congo red stain positive and apple green birefringence on polarised light. Immunohistochemistry (IHC) was positive for serum amyloid A (SAA) protein suggesting renal AA amyloidosis. Thus, a renal biopsy is mandatory to look for other etiologies, even though the incidence is rare.