Abstract: People with AIDS are highly prone to opportunistic infections, among which pulmonary infections are the most common, with high incidence and fatality rates. How to effectively prevent or reduce the occurrence of HIV-related lung infections (HRLI) is of great practical significance. From the perspective of traditional Chinese medicine (TCM), HRLI and AIDS share common pathological mechanisms, including qi deficiency, spleen deficiency, phlegm-heat or phlegm-dampness obstructing the lungs. Based on the TCM theory of "preventing disease before it occurs", the three-level prevention approach includes: the first step "preventing disease before it occurs" emphasizes strengthening the body′s defense mechanisms by tonifying the spleen and benefiting qi, and nourishing the lungs and kidneys to strengthen the exterior and protect the body; the second step "preventing the progression of disease once it occurs" emphasizes the removal of pathogenic factors while strengthening the body′s defenses. Based on the principles of syndrome differentiation and treatment in TCM, focuses are kept on the spleen tonifying and phlegm resolving, pathogenic factors dispelling and dampness eliminating, while protecting the spleen and nourishing other organs. The third step "preventing relapse after recovery" emphasizes replenishing deficiencies and enhancing immunity. Adopting the three-level prevention approach and early intervention can reduce the incidence of HRLI, which is a new idea for the prevention and treatment of HRLI with TCM.