Minimal change disease (MCD) is typically not a disease seen in adults as it comprises only 10-15% of cases (1). Disease can be further characterized as primary/idiopathic or secondary. Typical secondary causes include drugs such as NSAIDs and Lithium and malignancies including Non-Hodgkin Lymphoma. Thus, secondary causes are often the culprit. We present a 47-year-old African-American female patient with a history of Multiple Sclerosis (MS) and HIV who presented with sudden onset worsening lower extremity edema and 6.6 grams (g) urine protein to creatinine ratio with primary MCD.