Preterm rupture of membranes is a bridge of fetal amniotic membranes before 37 weeks of pregnancy. The association between ruptured membranes and maternal morbidity and fetal complications and fetal demise especially that the earlier it occurs the more serious the morbidity and mortality. As the amniotic membranes form the barrier to prevent infections to the fetus, the disruption will lead to easier passage of infection to the fetus. HIV infection is not exempted from being transmitted and therefore the impact of preterm rupture of membranes on HIV transmission was investigated. Patients’ records of those who had preterm rupture who were HIV infected compared with HIV non-infected from 26 weeks until 34 weeks of pregnancy were retrospectively analyzed. Hospital length of stay, maternal and fetal complications including rate of HIV vertical transmission and perinatal deaths were included in the analysis. 120 HIV infected women and 60 HIV non-infected medical records were reviewed, 95% of HIV infected patients had undetectable viral copies as they were already on treatment. Of those with detectable viral copies the mean viral copies was 1200. 107 neonates were admitted in the neonatal unit with congenital sepsis, meconium aspiration syndrome and respiratory distress irrespective of HIV status. All preterm deliveries between 26 and 27 weeks gestation had a 100% neonatal mortality. Of the surviving neonates only 4 had a positive birth HIV PCR. Preterm rupture of membranes at an early weeks of gestation is associated with higher neonatal mortality. Rupture of membranes is associated with increased rates of HIV vertical transmission. HIV viral suppression had comparable outcome to HIV non-infected mothers.