Vertical transmission of HIV from mother to child during pregnancy remains a significant public health challenge, particularly in resource-limited settings. Despite advancements in antiretroviral therapy (ART), many infants are still born with HIV, underscoring the need for a deeper understanding of the immunological landscape during pregnancy. Eosinophils, traditionally associated with allergic reactions and parasitic infections, are increasingly recognized for their complex roles in immune modulation. This review explores the potential contributions of eosinophils to the vertical transmission of HIV, focusing on their interactions with other immune cells, cytokine production, and the implications for maternal-fetal health. Eosinophils are multifunctional granulocytes involved in both innate and adaptive immunity. They produce a variety of cytokines and chemokines, influencing the activity of other immune cells such as T cells and macrophages. During pregnancy, the maternal immune system undergoes significant changes to tolerate the semi-allogeneic fetus, with eosinophils playing a role in tissue remodeling, angiogenesis, and the regulation of immune responses. Their presence at the maternal-fetal interface suggests they could be crucial in modulating the immune environment, potentially impacting HIV transmission dynamics.