The study was undertaken to determine the prevalence and severity of malaria in HIV positive pregnant and non-pregnant women who receive antiretroviral therapy (ART). The level of malaria prevalence, disease severity (as measured by parasite density and Hb level); and immune status (as measured by CD4+± T cell count) were determined for 500 HIV positive women from Adama hospital and ‘Awash Sebat Kilo’ health center. 18.4% of the HIV positive women were pregnant and a total of 22.2% were malaria infected. Among the pregnant HIV positive women, 44.6% were malaria infected. Compared to the non-pregnant HIV/malaria co-infected, pregnant HIV/malaria co-infected women, on the average, had a significantly higher (P