Nutritional anaemia in pregnant women continues to be one of the major public health challenges. Anaemia contributes to one fifth of the maternal deaths and large number of preterm deliveries and low birth weight babies in India. The objective is to study the prevalence, various epidemiological factors, clinical presentation in pregnancies complicated with iron deficiency anaemia in a tertiary care teaching hospital in central India. A Prospective observational study was conducted for a period of two years from September 2012 to August 2014. A total of 1644 pregnant women were investigated for evidence of iron deficiency anaemia by performing haemoglobin estimation and peripheral blood smear examination. Information on epidemiological factors was collected through interview and information on clinical profile was collected in predesigned and pretested structured proforma. Statistical analysis was done by finding out percentages, proportions, Mean and Standard deviation (SD), Chi square test. It is found that the prevalence of anaemia among pregnant women was 49.40%. Mild, moderate and severe degree of anaemia was seen in 19.46%, 25.06% and 04.86% cases respectively. Prevalence of anaemia was more in women with early marriages and teenage pregnancies, women without antenatal care, who had not taken iron folic acid tablets, who were less educated and who belonged to families with low per capita income, from rural area and those who were grand multi-gravida with short inter-conceptional period of less than 24 months in regards to the index pregnancy. The study revealed high prevalence of iron deficiency anemia among rural pregnant population. Improvement in female literacy, health education, prevention of early marriages and teenage pregnancies, strengthening the peripheral health care delivery system , improving contraceptive use and provision of safe abortion facilities to control unregulated fertility can reduce the prevalence of anaemia in pregnancy