Purpose of review <p>We summarize the epidemiology, biology, management and prevention of HSV-2 and HIV in pregnancy.</p> Recent findings <p>The seroprevalence of HSV-2 is higher in people living with HIV than in HIV-negative people, and 75% of women with recurrent genital herpes may have a recurrence during pregnancy. Those with a history of recurrent genital HSV infection should be offered acyclovir/valacyclovir at 36 weeks gestation to decrease need for C-section. The most important intervention for reducing HIV vertical transmission is maternal antiretroviral therapy (ART) to suppress HIV replication. Maternal ART also reduces HSV-2 cervicovaginal shedding and thus, HSV-2 vertical transmission. HSV-2 viral shedding is incompletely suppressed with acyclovir/valacyclovir, and newer drugs such as the helicase-primase inhibitors show promise but have not been studied in pregnancy. Safe options also exist for preventing HIV acquisition in pregnancy but remain in development for HSV-2.</p> Summary <p>Safe, effective HSV-2/HIV management strategies exist in pregnancy.</p>