Introduction: Tenofovir disoproxil fumarate (TDF) is a key antiretroviral agent for preventing mother-to-child transmission of human immunodeficiency virus (HIV) and treating chronic hepatitis B (HBV) during pregnancy. However, concerns persist regarding its potential effects on bone metabolism during foetal development and postpartum recovery. Objective: This scoping review synthesised evidence on the impact of Methods: A systematic search of PubMed, Scopus, Web of Science and the China National Knowledge Infrastructure identified randomised controlled trials, cohort studies, and observational studies assessing bone mineral density, bone mineral content, growth, or bone turnover markers in relation to perinatal TDF exposure. Thirty-one studies met the inclusion criteria. Results: Most studies reported no clinically significant long-term effects of TDF on paediatric bone mineralisation, growth, or metabolism from infancy to mid-childhood. A transient reduction in neonatal bone mineral content was noted in a few studies, but its clinical relevance appeared limited. In contrast, TDF use in mothers was consistently associated with accentuated bone loss during pregnancy and lactation, particularly at the hip, with incomplete recovery postpartum, indicating potential long-term skeletal risk. Conclusions: