The 18th Conference on Retroviruses and Opportunistic Infections maintained its tradition of being the preeminent forum for detailing the state-of the-art in antiretroviral therapy. There were important presentations on investigational antiretroviral drugs, clinical trials in treatment-experienced patients, and new antiretroviral strategies. Relevant data on resistance to antiretroviral drugs and pharmacokinetic interactions were discussed. There were extensive presentations on antiretroviral therapy in resource-limited settings, including large-scale clinical trials, scale-up of antiretroviral therapy, adherence, retention in care, and treatment outcomes for children and adults. Prevention of mother-to-child transmission continued to be an important part of the conference.