Low income pregnant HIV positive women appear vulnerable because of a host of challenges associated with their economic, HIV, and pregnancy status. This study attempted to explore their psychological distress and resilience level, associated socio-demographic factors and possible relationships between distress and resilience. For this purpose, a sample of 44 Low income pregnant HIV positive women were drawn to be compared with two parallel groups of a similar background (42 Low income pregnant but HIV negative and 34 low income non-pregnant but HIV positive groups) from Addis ketema Kifle ketema. Psychological Distress Scale and Resilience Scale were employed to generate data from this group along with other background search questions attached to these scales. Findings indicated that although psychological distress was significantly correlated with the resilience of participants, these two variables were characteristically different among the participants in so many ways. First and foremost, while low income pregnant HIV positive women were significantly more distressed than the other groups, resilience score was found to be comparable among the three groups. Furthermore, although housing status and number of children were not making significant differences in psychological distress and resilience level and yet marital status was rather an important factor in both cases such that the currently non-married groups were significantly more distressed and less resilient, educational level and place of birth were, however, noted playing a different role in the two variables. That is, while psychological distress seemed to significantly reduce with increase in educational level, this difference in educational level didnâ€™t, however bring differences in resilience score. In the same way, while place of birth didnâ€™t affect psychological distress, the outside Addis Ababa groups were, however, found to be more resilient. Recommendations were given as to how to intervene to reduce psychological distress and boost resilience.