According to National AIDS Control Organization of India, NACO, in 2003 there were 530,000 new HIV infections in India with women accounting for a significant number. This raises the issue of HIV prevalence among pregnant women and the transfer of HIV from mother to child (MTCT) especially in states such as Tamil Nadu where the HIV prevalence rates among pregnant women exceeds 1%1. To prevent MTCT various voluntary counseling and testing (VCT) programs have been implemented but baseline data regarding knowledge, attitude and practice towards HIV/AIDS among the pregnant women in many of the regions is lacking. The goal of this study was to determine the general baseline knowledge regarding HIV/AIDS along with attitudes and practices towards HIV/AIDS among rural women in the Namakkal district presenting for antenatal care at government health facilities. Our results show that about 50% of the women did not think or did not know that HIV transmission from person to person can be prevented and also about 60% of the women did not think or know that MTCT can be prevented. Almost 90% of the women did not know where they can get testing for HIV and 80% did not know where they can go to receive PMTCT services. The majority of the women (70%) indicated they would accept medication to reduce MTCT, however only 32% were willing to accept HIV testing if pregnant. These findings help to identify the gaps in knowledge regarding HIV/AIDS among pregnant women and the barriers they face. Future VCT sessions need to take these factors into consideration to overcome such barriers and to increase the effectiveness of VCT and to reduce MTCT.