The management of live attenuated vaccines (LAVs) in infants exposed in utero to TNF inhibitors (TNFi) has evolved following the updated 2024 EULAR recommendations. We retrospectively reviewed infants exposed to TNFi during pregnancy between 2021 and 2024 at a tertiary centre who received LAVs within the first 6 months of life. Of 29 exposed infants, 18 received at least one LAV before 6 months of age. Rotavirus vaccine was administered to 17 infants and BCG to 5, including two infants exposed to adalimumab until 27 and 28 weeks’ gestation. No vaccine-related adverse events, serious infections or hospitalisations were observed. These findings provide additional real-world evidence supporting the safety of live attenuated vaccination after in utero TNFi exposure.