Interleukin (IL)-1 beta is a key innate cytokine that is essential for immune activation and promoting the inflammatory process. However, abnormal elevation in IL-1 beta levels has been associated with unwanted clinical outcomes. IL-1 beta is the most extensively studied cytokine among the IL-1 family of cytokines and its role in pathology is well established. During the course of human immunodeficiency virus type 1 (HIV-1) infection, the level of this proinflammatory cytokine is increased in different anatomical compartments, particularly in lymphatic tissues, and this elevation is associated with disease progression. The aim of this review is to address the pathological roles play by IL-1 beta in the light of enhancing HIV-1 replication, driving immune cell depletion, and chronic immune activation. The role of IL-1 beta in HIV-1 transmission (sexually or vertically 'from mother-to-child') will also be discussed. Additionally, the impact of the available antiretroviral therapy regimens on the levels of IL-1 beta in HIV-1 treated patients is also discussed. Finally, we will provide a glance on how IL-1 beta could be targeted as a therapeutic strategy.