Background: HIV-seropositive patients are increasingly undergoing open-heart surgery in the 21st century. This case series evaluates three HIV-seropositive patients who underwent aortic root surgery with the concomitant utilization of conventional ultrafiltration during cardiopulmonary bypass (CPB) as a blood conservation technique. Methods: IRB approval was obtained for this case report. Three males (ages 44, 34, and 58) presented for surgical correction of aortic dilation; the patients underwent Bentall procedure, David procedure with Shafer repair and David procedure with hemi-arch repair, respectively. Patients underwent uneventful anesthesia induction and initiation of CPB. During cardiopulmonary bypass, conventional ultrafiltration was initiated as an additional blood conservation maneuver in an effort to avoid allogenic blood transfusion; all three patients were successfully weaned from cardiopulmonary bypass. Results: Conventional ultrafiltration was implemented for all three patients. No blood products were transfused intra-operatively or post-operatively. All of the patients were successfully discharged home with no complications. Conclusion: This case series demonstrates that conventional ultrafiltration may be a useful adjunct for blood conservation during cardiothoracic procedures requiring CPB in HIV-seropositive patients. Although conventional ultrafiltration is classified as a class IIb intervention by the Society of Thoracic Surgeons, this modality should be considered as part of the multi-modal approach for blood conservation in HIV-infected patients undergoing aortic root surgery.