Amoebic colitis is common in developing countries, with variable and non-specific symptoms. The unusual findings of colon involvement include fulminant colitis and its complications, such as chronic abscess formation mimicking colonic neoplasms. Patients with acquired immunodeficiency syndrome are part of the highest risk invasive amoebiasis group that led to death probably, especially if wrong diagnosis or delayed treatment happens. We report a case of an AIDS patient with amoebic colitis whose presenting symptoms and radiological findings closely resembled those of colonic neoplasm.