Background; Tanzania adapted the World Health Organization (WHO) policy of giving two doses of Sulfadoxine- Pyrimethamine (SP) to pregnant women attending Antenatal clinics (ANCs) in order to control malaria in pregnancy. Studies have shown that low level of knowledge on the use and benefits of SP-IPT being a challenge facing the implementation of IPT policy, thus not achieving the target coverage of 80%. Purpose; the aim was to assess knowledge and awareness of the use and benefits of Sulfadoxine-Pyrimethamine for intermittent preventive treatment to pregnant women attending antenatal clinic at KCMC hospital. Methodology; the study design was a hospital based cross-sectional study. Simple random sampling technique was used to select a total of 326 pregnant women, 188 met the inclusion criteria and were enrolled in the study. Data was collected through questionnaires. Then, data was entered manually, processed and analyzed with aid of computer using the SPSS software. Frequency and percentages was used to summarize categorical data while measures of central tendency and respective measure of dispersion was used for numeric data. Results; 188 patients were enrolled into the study. Their median age was 29, ranged from 24 to 44. 77% were urban dwellers and 80% had at least secondary education. Majority (82%) of pregnant women were aware of IPT, of these, 62% mentioned SP to be the drug used for IPT. 80% of the pregnant women had good knowledge on the time for initiating IPT and 82% of pregnant women had good knowledge on dosage of SP for IPT. The coverage of IPT at KCMC was found to be 90%. Conclusion; most of pregnant women were aware of SP-IPT and had high knowledge on the use and benefits of SP for IPT. So for effective implementation of IPT policy, pregnant women should be sensitized and educated on the use and benefits of SP for IPT.