Dissertation (MSc Midwifery)Introduction: Anaemia in pregnancy remains a major health problem with adverse maternal and fetal outcome worldwide, especially in developing countries such as Tanzania. Taking proper nutrition, including taking iron supplement, child spacing and absence of negative food cultural practices and taboos, may prevent anaemia during pregnancy. The study aimed to establish prevalence, nutrition and obstetric factors associated with anaemia among pregnant women at Mnazimmoja, Mwembeladu and Kivunge hospital antenatal care visit at Unguja Island in Tanzania. Method: Analytical cross- sectional study design with quantitative approach was employed. Simple random sampling was used to select 338 pregnant women in different trimesters of pregnancy. Participants were enrolled in the study at the time when they were visiting at RCH clinics. All participants were given informed consent form obtained prior to data collection. Statistical Packages for Social Sciences (version 21) was used for both data entry and analysis. Descriptive statistics was used to analyze demographic characteristic and presented by using frequency table, Cross-tabulation and logistic regression for categorical variables, were mainly used to study the association between the response variables and the set of explanatory variables. Results: The overall prevalence of anaemia in pregnant women was (80.8%), 60.65%had mild anaemia, 11.24% had moderate anaemia and 0.8 9% had severe anaemia. The study also has observed a higher (82.9%) prevalence of anaemia in the third trimesters of pregnancy as compared in the first trimesters (82.4%) and second trimesters (78.3%).In logistic regression and multivariate analysis the result showed that gravidity, (AOR= 1.185, 95%CI= 0.317-4.338,p <0.001),number of meals,(AOR=3.176,95% CI =1.652-6.109, p <0.001),irregular taking of iron tablets (AOR= 0.288, 95%CI = 0.149-0.556,p<0.001), nutrition score (AOR= 30.358, 95% CI= 14.725-62.585,p<0.001), age of the child < 2 years, (AOR 3.635, 95% CI= 1.103 -11.882, p< 0.034) and education level,(AOR=9.179,4.851, 95% CI= 3.140-26.832, p<0.001) were found to be significantly associated with anemia in pregnancy. Conclusions: Timely and regular intake of iron tablets and adequate nutrition intake during pregnancy may significantly reduce the prevalence of anaemia among pregnancy women.