In Israel, the caseload and main modes of transmission have changed dramatically since 1991 after mass immigration from countries with generalized HIV epidemics. The previous annual average (of 60 new cases) has almost quadrupled, and 68% are among heterosexuals (compared with 11.6% before). We verified all HIV/AIDS cases ever documented, redefined (according to UNAIDS/WHO definitions) and analysed those aged 13+. Between 1980-2000, HIV and AIDS were diagnosed, respectively, in 2204 and 682 adults and adolescents (cumulative HIV infection rate = 61/100 000). Of these, 65.2% are male (mean age 35.0 years old; SD = 11.0), 31.5% female (mean age 31.4 years old; SD = 10.5) (and 3.3%, sex unknown). The main modes of HIV transmission were heterosexual (45%), MSM (16.9%) and IDUs (11.5%). Prevention measures must be strengthened, if the currently low-level of HIV epidemic among the Israeli general population is to be sustained.