This article explored the differences in HIV testing in the elimination of mother-to-child transmission of HIV (EMTCT) between women with and without disabilities aged 16–55 years, reported being pregnant and receiving the social cash transfers (SCT) social safety nets in Luapula province, Zambia. We tested for associations between HIV testing in EMTCT and disability using logistic regression analyses. We calculated a functional score for each woman to determine if they had mild, moderate or severe difficulties and controlled for age, intimate partner sexual violence, and the SCT receipt. Of 1692 women, 29.8% (504) reported a disability, 724 (42.8%) mild, 203 (12.0%) moderate, and 83 (4.9%) severe functional difficulties (adjusted odds ratio [aOR] 1.33; 95% confidence interval [CI] 1.04–1.70). Women with moderate (aOR 2.04; 95% CI 1.44–2.88) or mild difficulties (aOR 1.66; 95% CI 1.32–2.08) or with a disability in cognition (aOR 1.67 95% CI 1.22–2.29) reported testing more for HIV than women without disabilities; Women with a disability in hearing (aOR 0.36 CI 0.16–0.80) reported testing less for HIV. Disability is common among women receiving the SCT in the study area accessing HIV testing in the EMTCT setting. HIV testing in EMTCT is challenging for women with disabilities in hearing.