Introduction: Prevention of mother-to-child transmission activities form important part of HIV/AIDS prevention program of any community or country. Methods: Information from the PMTCT Programme from the Ministry of Health and other published literature on HIV in Bhutan were reviewed. Results: The first case of mother to child transmission was reported in Bhutan in 2001. However, the retrospective study shows that one of the earliest mothers-to- child transmissions could have taken place back in 1997. Strategies for the prevention of mother-to-child transmission (PMTCT) of HIV in Bhutan have endured substantial advancement based on global scientific evidence. It is a concern as there is a slow rise in the number of HIV cases. The main modeof transmission is unsafe heterosexual practice in Bhutan. Before the planned PMTCT program, 3 children were infected. After launch of proper PMTCT program, we had all the components of effective strategies in PMCT program which have evolved with better ones with time. Due to this, MTCT was 3.2%. With undetected HIV infections, 32 children were born outside of the program and actual national MTCT rate is 5.5%. Conclusion: There is increasing number of people every year with new HIV infections. In addition, our detection gap is 45% with about 602 undiagnosed in the community. Every effort should be put forward to upscale the PMTCT program for Bhutan to eliminate Mother-to-Child transmission (MTCT) of HIV by 2020 and beyond.