Background: Tetanus toxoid (TT) vaccine is still recommended for pregnant women even in countries that declared elimination of neonatal tetanus (NT) and consequently the maternal tetanus (MT). Many factors may affect TT vaccination during pregnancy. Objective(s): This study was conducted to identify the factors affecting maternal tetanus vaccination among a sector of Egyptian women in Dakahlia governorate. Methods: A cross-sectional study design was used throughout the study. Two-stage cluster sampling technique was used to interview a total number of 3780 women with children of 0–11 months old in the eighteen districts of El-Dakahlia governorate, Egypt. Women were interviewed by using the "standard WHO EPI TT immunization of women cluster form". Results: About two thirds (63.2%) of surveyed women received the full recommended doses of TT vaccine. Receiving of TT vaccine was significantly higher among women who had one or two parities, and 1.5 times higher among women who had at least four antenatal follow up visits. Factors that hindered TT vaccination were not being advised by doctors, and inconvenient time of vaccination sessions as reported by 54.8% and 34% of interviewed women, respectively. Lack of awareness about vaccine importance, and vaccine schedule were reported by 18.9%, and 16.2% of surveyed women, respectively. Conclusion: Number of parity, frequency of seeking antenatal care, advice of healthcare providers, and lack of awareness were the main identified factors that affected receiving TT vaccine during pregnancy.