Objective:To evaluate factors associated with prevalence of malaria parasitaemia at first antenatal care visit.Methods:The study was conducted at the University of Calabar Teaching Hospital from 1st June,2007 to 31st July,2007.A structured questionnaire was administered to a total of 545 pregnant women that were recruited in this study after obtaining informed consent and two slides of thin and thick films were prepared for each participant.Results:Five hundred and twenty(95.4%) out of the 545 participants suffered from malaria parasitaemia,the rest 4.6%of those who had no parasitaemia had experienced symptomatic malaria before and were treated in private hospitals prior to their recruitment into the study.All participants(100%) who did not have antimalarials had parasitaemia compared with 91.1%among those that had antimalarials.The proportion of moderate to severe parasitaemia was also significantly higher among the former.Besides,the difference in parasitaemia between primigravidae and multigravidae was statistically significant(P=0.000) too. Among the methods used for vector control,only insecticide treated nets(ITNS) was associated with significant reduction in the level of parasitaemia(RR=0.83).Conclusion:Malaria parasitaemia at first booking is significandy higher in primigravidae and women who have no anti-malaria treatment. The use of safe and effective antimalarial treatment along with ITNs will significandy reduce the level of parasitaemia in pregnant women. Objective: To evaluate factors associated with prevalence of malaria parasitaemia at first antenatal care visit. Methods: The study was conducted at the University of Calabar Teaching Hospital from 1st June, 2007 to 31st July, 2007.Associan questionnaire was administered to a total of 545 pregnant women that were recruited in this study after obtaining informed consent and two slides of thin and thick films were prepared for each participant. Results: Five hundred and twenty (95.4%) out of the 545 participants suffered from malaria parasitaemia, the rest 4.6 % of those who had no parasitaemia had experienced symptomatic malaria before and were treated in private hospitals prior to their recruitment into the study. All participants (100%) who did not have antimalarials had parasitaemia compared with 91.1% among those that had antimalarials. proportion of moderate to severe parasitaemia was also significantly higher among the former.Besides, the difference in parasitaemiabetween primigravidae a Among the methods used for vector control, only insecticide treated nets (ITNS) was associated with significant reduction in the level of parasitaemia (RR = 0.83) .Conclusion: Malaria parasitaemia at first booking is useful and safe for effective antimalarial treatment along with ITNs will significandy reduce the level of parasitaemia in pregnant women.