This economic evaluation book deals with the comparison of alternative service delivery approaches of PMTCT of HIV in terms of both their cost and consequences (effectiveness). The comparative strategies includes: no intervention, opt-in approach of PMTCT service delivery, opt-out approach of PMTCT service delivery, mandatory HIV testing approach of PMTCT service delivery and Universal treatment. Moreover, the book will also discuss on the average cost of voluntary counselling and testing per pregnant women (in ANC and labor and delivery), which varied with the ranges of 2.14 birr ($0.22) to 133.75 birr ($13.55) based on the amount of service received by the client. Cost Effectiveness Analysis among the three alternatives (no interventions, opt-in and opt-out approach) showed that the opt-out approach would be the most cost effective approach; that costs 9,597,906.62 birr ($972,038.34) and avert 640 cases at CER of 1,989.76 birr ($201.51). If the comparison is extended to include mandatory HIV testing and Universal treatment approaches, adopting the universal treatment would be the cost-saving modality, with an estimated cost-saving of 60,206.27 birr ($6,097.45) at CER of $ 9.71.