The advent of potent antiretroviral therapy coupled with the dramatic reduction in mother-to-child transmission seen over the past decade has allowed women with HIV infection to live longer, healthier lives and has affected their fertility desires. As a result, preconception health care for HIV-infected women should be a routine part of primary health care. Such counseling includes health recommendations and counseling for safer sexual practices, contraception, and pregnancy planning, identifies individual risks and corresponding interventions, provides personalized and nonjudgmental education, and provides access to integrated services that address all of a woman's health and psychological needs. The goals are: (1) to improve the health of the woman before conception; (2) to identify risk factors for adverse maternal or fetal outcomes and initiate interventions to optimize outcomes; and (3) to prevent transmission of HIV to infants as well as sexual partners. This article will review the components of preconception health care for HIV-infected women.