Background: Iron deficiency anemia (IDA) during pregnancy is a universal public health problem. There is geographical variation in the prevalence and risk factors. Objectives: This study aims to measure the prevalence and risk factors for IDA among pregnant women attending antenatal care in Qena city. Patients and Methods: This is a hospital based cross sectional study in two hospitals in Qena city, Qena General hospital and Qena University hospital. Informed consent from women was taken. Review of 1000 pregnant women with IDA was done. Data were collected using pretested interviewer administered questionnaire.  Blood hemoglobin concentration was done. Anemic women had serum iron & ferritin tested to confirm the presence of IDA. Results: The prevalence of IDA was 37.4%. Multiple logistic regression analysis identified 5 risk factors of anemia during pregnancy, these are the age group 30- <35 years (AOR: 3.968; CI:1.135-13.878; P value:  0.03), the birth spacing ≤ 2 years (AOR: 3.089; CI: 2.293-4.161), the low socioeconomic status (AOR: 4.794; CI:2.940-7.819; P value: < 0.001), the second trimester (AOR: 3.120; CI:1.912-5.092; P value: < 0.001), and the absence of iron supplementation (AOR: 1.507; CI: 1.105-2.055; P value: 0.01).   Conclusion: The prevalence of IDA during pregnancy was 37.4%. There were five risk factors related to IDA during pregnancy: women age, birth spacing < 2 years, low socio-economic status, second trimester, and no iron supplementation during the pregnancy