Background: The advent of HIV/AIDS has changed global health. Although no cure has been found yet, the introduction of highly active antiretroviral therapy (HAART) has greatly improved the quality of life and thus increased the life expectancy of HIV positive patients. HAART has helped to reduce vertical transmission of HIV. However, the current status of perinatal and neonatal outcome among HIV positive pregnant women on modern HAART regimen has not been well documented in our environment. Objectives: To determine the relationship between CD4 count and viral load on preterm delivery, low birth weight, stillbirth and infant HIV positivity in babies delivered to HIV positive pregnant women on HAART. Methods: This is a prospective study carried out among booked HIV positive patients attending the antenatal clinic in Lagos University Teaching Hospital (LUTH) over a period of eight (8) months (January to August 2014). All booked HIV positive patients from 28 weeks who consented to participate in the study were recruited and followed up till delivery. Socio demographic data and history related to HIV infection and HAART therapy were obtained from the participants with the aid of a structured proforma and their babies were followed up further for 6 weeks after delivery to confirm their HIV status. Fetal and neonatal outcome such as gestational age at delivery, birth weight, stillbirth and infant HIV positivity were documented. Data were analysed using SPSS software version 20 for windows. Independent- samples t- test was used to determine the association between the means of the maternal viral and CD4 counts and fetomaternal outcomes. Levels of statistical significance was set at P<0.05.