Antiretroviral therapy (ART) rotation in HIV patients who have achieved and are maintaining virological suppression is an important part of modern HIV care. Developments in the field of antiretroviral drugs have improved their tolerability and expanded the availability of simplified regimens with one pill a day. Treatment goals have moved beyond viral suppression alone toward long-term safety and durability of treatment. The modern approach to HIV treatment emphasizes optimizing patient adherence to treatment and improving their quality of life. These advances enable an individualized approach to treatment based on the needs of a particular patient. The rotation and modification of antiretroviral regimens is therefore a key component of contemporary care for people living with HIV.