The standard methods to monitor HIV infection are flow cytometry-based for CD4+ T lymphocyte count and molecular assays to quantify plasma viral load of HIV. Few laboratories in resource-limited countries can run these tests as a majority of the HIV infected individuals are poor. A number of currently available low-cost assays which require less expensive equipment and reagents, may be well-suited to such countries. These include manual and ELISA based CD4 cell assays, and ultrasensitive reverse transcriptase quantitation (Cavidi) and p24 (ELAST) assays to monitor virus load. But better internal quality assurance and quality control (QA/QC) programmes are essential. This review discusses the low-cost assays and their role in clinical monitoring of HIV infected individuals in resource-limited countries like as India.