Transmission of HIV-AIDS from mothers to their children are of increasingly concern and it remains an iceberg phenomenon. West Java is one of five provinces in Indonesia with highest cases of HIV-AIDS as well as maternal and infant mortality rates. Prevention of mother to child HIV transmission (PMTCT) program has been implemented in Indonesia since 2004. Ministry of Health has appointed several hospitals as centers of referral of PMTCT in the same area, however, its implementation has not been known yet. The aim of this research is to find out the preparedness of PMTCT services in four referral hospitals in West Java Province, namely HS Hospital, KBd Hospital, KBk Hospital, and MM Hospital. The preparedness of PMTCT services can be assessed from preparedness of medical staff and supporting staff in providing such services, the preparedness of facilities and infrastructures, and constraints of service as well. The study carried out in 2014 with qualitative approach. The result shows that there are some differences of preparedness amongst four hospitals in PMTCT service implementation, mostly because of unpreparedness in terms of facilities and infrastuctures (reagents, medicines, medical equipment, rooms, laboratories), lack of training, stigma from medical staff, and there is no guarantee for occupational safety and health of medical staff in providing PMTCT services. The conclusion of the results is that HS Hospital is the most well-prepared in PMTCT service implementation, whereas KBd Hospital needs medicine equipment and laboratories for HIV-AIDS examination. Similarly, KBk Hospital needs awareness campaign and training to reduce negative stigma from medical staff. Lastly, MM Hospital needs awareness campaign, training, completeness of personal protective equipment, leadership commitment and other supports for birth delivery services for HIV positive mothers.