There is growing recognition that HIV-exposed children might have poorer developmental outcomes compared with HIV-unexposed children, particularly in low-income and middle-income countries. Several studies have reported impairments in cognitive, language, or motor function. Other studies did not find substantial differences between HIV-exposed and HIV-unexposed children. Given that data are inconsistent, the exact nature of developmental delay and the clinical relevance in HIV exposed infants remain unclear. Identifying the children most susceptible to delays in neurodevelopment is necessary to focus interventions and improve child health outcomes. Therefore, understanding whether neurodevelopment is impaired in the expanding population of HIV-exposed children in this region is important, and studies are needed to ascertain the exact nature of any developmental delay with appropriate controls in the current ART era.