Aflatoxin B (AFB) and fumonisin B (FB) are poisons that contaminate poorly stored staple foods in resource-limited settings. Antenatal AFB and FB exposure may cause anaemia. We aimed to determine the associations of urinary aflatoxin M (AFM) and FB, biomarkers of AFB and FB exposure, respectively, with erythrocyte parameters and anaemia. A retrospective cross-sectional study was conducted in 68 HIV-infected and 61 HIV-uninfected pregnant women ≥ 20 weeks gestational age in Harare, Zimbabwe. AFM and FB were measured in urine via competitive ELISA, and levels were grouped into tertiles. The erythrocyte parameters assessed were haemoglobin (Hb), mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell (RBC), haematocrit (HCT), and red blood cell distribution width. Associations of urinary AFM and FB with erythrocyte parameters, and anaemia were assessed in a multiple regression controlled for potential confounders. The presence of FB in urine decreased Hb levels in all women (β= -0.98, 95% CI: -1.94, 0.02) and HIV-uninfected (β= -1.99, 95% CI: -3.71, -0.26). FB tertile 3 decreased Hb levels (β= -0.88, 95% CI: -1.74, 0.01) and HCT levels (β= -2.65, 95% CI: -5.26, 0.03) in HIV-infected. AFM tertile 2 decreased RBC levels in HIV-infected (β= -0.34, 95% CI: -0.71, -0.03). The presence of FB in urine increased anaemia risk in HIV-uninfected (OR: 10.68 95% CI: 1.02, 112.34). AFM tertile 2 increased macrocytic anaemia risk in HIV-infected (OR: 13.72, 95% CI: 0.92, 203.55). There is need to ensure food safety through monitoring and nutritional interventions to improve maternal-infant health outcomes.