OBJECTIVE: Knowledge, attitude and practice of pregnant women toward prevention of mother to child transmission of HIV infection have not been evaluated in any tertiary health facility in the Northeast region of Nigeria. METHODS: A structured questionnaire was used to obtain data from 172 women that consecutively attended the antenatal clinic of University of Maiduguri Teaching Hospital to determine their level of knowledge, practice and attitude toward HIV/AIDS issues with respect to PMTCT. RESULTS: The survey revealed a high level of knowledge on modes of transmission, risks behaviours and prevention of HIV and other sexually transmitted infections among the pregnant women. However, the use of breast milk substitute (BMS) by HIV positive nursing mothers and use of condom during sexual intercourse did not receive very encouraging responses from 42 (24.4%) and 58 (33.7%) of the women respectively. Those that do not encourage use of BMS indicated spouse dislike as a major reason and the fact that the community places higher premium on breastfeeding than BMS. Majority of those that discouraged condom use 28 (48.3%), said the practice was against their religions beliefs while a few believes withdrawal before ejaculation and use of antibiotics after sex can equally prevent HIV infection. Majority of the respondents, 106 (61.6%) admit their willingness to support their spouses that tested positive for HIV. CONCLUSION: The pregnant women accepted PMTCT as a veritable means of preventing infants from HIV infection as well as an opportunity to know ones HIV status through voluntary testing. Majority implored greater involvement of their male partners and other significant family members during PMTCT counselling sessions to guard against ejection, stigma and discrimination if tested HIV positive. Staff training, awareness creation and community mobilization were identified as key to success of PMTCT programmes and fight against stigma and discrimination.