Voluntary Counseling and Testing for HIV is an effective and important strategy for prevention, care and support. The study examines factors affecting utilization of VCT among pregnant women in Lesotho. A combination of quantitative and qualitative methods was employed. The majority of pregnant women have never been tested for HIV/AIDS. Married women were less likely to go for VCT as compared with those who are not married. The study also established that place of residence, education and marital status were significantly associated with knowledge of HIV/AIDS and ever been tested for HIV. Stigma and discriminations and fear associated with HIV testing were highlighted as the main factors hindering the use of VCT services among pregnant women. However, knowing one''s status in order to access early treatment was the main reason for utilizing VCT.