Objective: To determine the prevalence of iron deficiency anemia and the dietary and socioeconomic factors associated with anemia in pregnant women living in a rural community setting in El Massara El Baled & Arab Salaam, Helwan Governorat, Eygpt.Design: A cross-sectional study was done upon 500 pregnant women (in their 2nd and 3rd trimester) attending 1ry health care units in rural areas in Helwan governorate through August 2010. The pregnant women were subjected to CBC analysis at the first time, after one month and two month in order to detect IDA (Microcytic Hypochromic), women with no CBC analysis were excluded and Hb < 11 mg/dl was considered anemic(WHO,2001).Data were collected as regards age, gravidity, parity, abortion, gestational age, menstrual history, and iron in diet, iron supplementation (drugs), contraception, and mode of delivery.Statistical Analysis: Chi-square and “t” tests (paired and unpaired) were applied to test the relationships among study variables.Rsultes: In this study the prevalence of IDA among pregnant women at 1st booking in all cases (500 cases) was 65.6% from these 79% was mild, 20.1% moderate and 0.9% was severe (<7ml/dl).The prevalence of IDA was higher among pregnant women with history of menorrhagia 91% reaching 93.4% after 3 months , with history of inadequate iron intake in diet 84.2% reaching 89.5% after 3 months , 82.7% of pregnant women taking no iron supplementation are anemic reaching 89.9% after 3 months. The risk of IDA is higher among multi-Para women that reach to 100% in 4th, 5th, 6th Para women. But there is no effect of the mode of delivery on the Hb result.Conclusion: the prevalence of IDA among pregnant women is very high in Egypt. Increasing prevalence of IUD use in Egypt, repeated child birth, in- adequate knowledge of nutritional value of various foods contribute to causes of iron deficiency anemia in Egypt. The study recommends an integrated intervention program to be considered prior to conception.