Kaposi’s sarcoma (KS) is a vascular malignancy associated with human herpesvirus 8 (HHV-8). In Africa, the commonest type is the AIDS-associated KS seen in immunocompromised individuals, infected with HIV. Although KS primarily affects the skin and mucosal surfaces, visceral involvement is also well-documented, with the lungs and gastrointestinal tract being the most frequently affected sites. Renal involvement in non-transplant patients remains exceptionally rare. We present a case of a 33-year-old HIV-positive woman with a history of non-adherence to highly active antiretroviral therapy (HAART), who developed disseminated KS involving the oral mucosa, lungs, gastrointestinal tract, liver, and the right kidney. She presented with respiratory distress, generalized lymphadenopathy, and a hyperpigmented sublingual mass. Histopathological examination of the oral lesion confirmed KS, and post-mortem findings revealed extensive tumor infiltration of multiple organs, including the right kidney. This case highlights the aggressive nature of disseminated KS in severely immunocompromised patients and underscores the critical importance of HAART adherence in preventing disease progression. Given the exceptional rarity of non-allograft renal KS, this report adds to the limited literature on its occurrence and emphasizes the need for heightened clinical awareness when evaluating advanced KS cases.