['To evaluate the cost-effectiveness of universal antenatal human immunodeficiency virus (HIV) testing in Hong Kong.', "Cost-effectiveness analysis from the health care provider's perspective.", 'Public antenatal clinics in Hong Kong.', 'All pregnant women who gave birth in Hong Kong during the inclusive period 1 September 2001 and 31 December 2004.', 'The primary endpoints were (i) the cost per HIV infection avoided and (ii) the cost per life-year gained.', 'From 2001 to 2004, a total of 160,878 deliveries were recorded in Hong Kong; and 75% of the corresponding women had HIV testing before delivery. In all, 28 women tested HIV-positive and gave birth to 15 babies, one of which was HIV-positive. The mother of the infected baby presented late in labour, without her HIV status being diagnosed and thus missed the opportunity for prompt intervention. Assuming a natural transmission rate of 25%, it was estimated that six out of seven anticipated HIV infections among the newborns had been avoided. The cost for implementation of the programme for the first 3 years was HKD12 227 988. Hence, the average costs per HIV infection averted and per discounted life-year gained were HKD2 037 998 and HKD79 099, respectively. Sensitivity analysis showed that both the coverage and the loss-to-follow-up rate were the major determinants of the cost-effectiveness of the universal antenatal testing programme in Hong Kong.'] Is universal antenatal human immunodeficiency virus ( HIV ) testing programme cost-effective despite a low HIV prevalence in Hong Kong?