A group of neonates born by elective Caesarean delivery to HIV infected mothers taking the antiretroviral agent Zidovudine, are presented. The three newborns were also treated with Zidovudine immediately postnatally, and developed functional distal bowel obstruction. The bowel obstruction resolved with conservative management and cessation of the oral antiretroviral agent. The combination of caesarian delivery and antiretroviral agents should be considered as a possible cause for delayed meconium passage and a functional distal bowel obstruction.