Background and Objectives: Anemia in pregnancy is highly prevalent and can have a significant effect on both maternal and fetal outcome. The most prevalent kind of nutritional anemia that occurs during pregnancy is iron deficiency anemia. Even with the use of oral iron prevention during pregnancy, IDA remains a significant health concern for expectant mothers. The current study intends to examine the treatment response and prevalence of IDA in a pregnant population. Methods: This is a retrospective cohort study looking into the prevalence of iron deficiency anaemia amongst pregnant women who delivered in a Tertiary care Hospital for a period of 2 years (Feb2022- Jan2024). All patients who got prenatal care at our hospital had their hemoglobin levels regularly evaluated at booking and at 28 weeks and 36 weeks pregnant and more often as needs by either a venous or capillary blood sample, are included in the inclusion criteria. We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers. SPSS was used for analysis. Results- the prevalence of anemia was found to be 59.4% (N=297) mostly being Iron deficiency anemia. 6 patients were Thalassemia minor and 1 patient was Sickle cell carrier The most common age group was found to be 20-35 years in which 60.2% were anemic. Around 59% of anemic had tertiary form of education and parity 63% for 2-4. The most common category was mild anemia (82%), moderate in 15%. After 36 weeks the anemia levels were improved in all category only 12.4% had mild while no severe anemia was seen. But this was not statistically significant (p>0.05). The incidence of PPH were 2.7% in treated anemic patients while 1.7% in anemic Conclusion: Anemia in Pregnancy is highly prevalent and if left untreated can have a significant effect on both Maternal and fetal outcome. Prevention, Health education on reproductive health from early childhood and Adolescent age is highly recommended.Eraly diagnosis and Prompt management of anaemia in Pregnant females by oral Iron or Iron infusion helps in a better outcome . Parenteral iron therapy should be used as soon as possible to enhance treatment outcomes. And also helps in avoiding the need for Blood transfusion.