Pregnant women are increasingly being initiated on antiretroviral therapy either as part of prevention of mother to child transmission of HIV or as purely highly active antiretroviral therapy. In this case report, we describe a 26 year old woman who was 28 weeks pregnant and who presented after 4 weeks of initiation of antiretroviral therapy with a herpes zoster eruption and how the case was managed at the Infectious Diseases Institute, Kampala, Uganda.