Anemia among pregnant women is a critical global health issue, significantly impacting maternal and fetal health outcomes due to its association with preterm delivery, maternal mortality, and developmental risks for infants. In Rwanda the prevalence of anemia among pregnant women was reported to be high which is 23.36% in 2019. Despite global efforts, Sub-Saharan Africa, including Rwanda, continues to grapple with high anemia prevalence rates, with Eastern Province specifically identified as a region of concern. This study aims to comprehensively assess the prevalence and factors associated with anemia among pregnant women in Rwamagana district, Eastern Province, Rwanda. Conducted as a retrospective cross-sectional study at Rwamagana health center from 1st July 2022 to 1st July 2024, the study targeted pregnant women who attended antenatal care during this period. A simple random sampling technique was employed to select a sample size of 288 participants, calculated based on a presumed anemia prevalence of 25% among pregnant women from previous surveys. Data was collected using structured questionnaires covering demographic, socio-economic, and dietary information, complemented by hemoglobin level assessments extracted from medical records. The reliability and validity of research instruments were ensured through pretesting at 10% of sample size, and adjustments made based on Cronbach's Alpha coefficient analysis. Ethical considerations were paramount, with approvals sought from Mount Kenya University and Rwamagana Health center ethics committees. Data analysis employed SPSS software, focusing on Chi square, AOR, CI and p-value to explore associations between anemia and socio-demographic, reproductive, and nutritional factors, presenting results through detailed tables and graphs. Confidentiality was strictly maintained through anonymous coding of participant data, and findings will contribute crucial insights to maternal health interventions, aiming to mitigate the burden of.