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Objective: There are conflicting report on the association of HIV infection and asymptomatic bacteriuria (ASB). Most of these studies were from areas with low HIV burden. This study determined the prevalence and risk factors of ASB in HIV positive pregnant women. Methods: A cross sectional study among HIV positive pregnant women seen at a large PMTCT clinic in Lagos Nigeria. The women were evaluated for ASB at first clinic attendance. Blood samples were also collected for viral load, CD4 count and hemoglobin levels assessment. Data were managed with SPSS for windows version 19. Results: 102 (18.1%) women out of 563 studied were found positive for asymptomatic bacteriuria. Ninety-seven (95.1%) of the positive samples yielded single bacterial isolates. Escherichia coli (44.3%) and Proteus mirabilis (21.6%) were the most common bacterial isolates. Previous urinary tract infection (OR: 4.3), HIV-1 RNA greater than 10,000 copies/ml (OR: 3.9), CD4 count <200 cells/mm3 (OR: 1.4) and maternal hemoglobin <11 g/dl (OR: 1.4) were factors significantly associated with ASB after controlling for possible confounders. Conclusion: ASB is common in HIV positive pregnant women in our environment and is associated with previous UTI, high viral load, low CD4 count and maternal hemoglobin <11 g/dl. [ABSTRACT FROM AUTHOR]