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HIV in pregnancy assumes additional importance because of the risk of perinatal transmission. With the increase in number of people living the HIV–AIDS worldwide, better ART policies and improved heath condition, more women with HIV are getting pregnant. Perinatal transmission occurs mostly during labour and delivery; transmission during antenatal period may also occur. Timely administration of appropriate ART, suppressed viral load, appropriate mode of delivery and safe feeding practices can reduce the risk of perinatal transmission to minimal. ART has evolved from single dose therapy to daily fixed-dose lifelong ART to all women irrespective of the clinical stage and CD4 count. NACO recommends tenofovir 300 mg + lamivudine 300 mg + efavirenz 600 mg once daily (TDF + 3TC + EFV) for all pregnant women to be continued lifelong after delivery. ART for the mother, safe mode of delivery, ART for newborn and exclusive breast feeding can together ensure a safe pregnancy for the mother and with minimal risk of perinatal transmission. This assumes importance in developing counties like India.