BackgroundMalaria remains a public health problem and the use of insecticide-treated bed nets (ITNs) against it in vulnerable groups (pregnant women and children <5 years) is recommended in Cameroon. This study was aimed at assessing the socio-demographic factors influencing the ownership and utilization of ITNs among vulnerable groups in the Buea Health District (BHD).MethodsIn a cross-sectional survey a questionnaire was administered in households with at least a child <5 years and/pregnant woman in five health areas of the BHD. Information on demographic variables, household composition, mosquito bed net (MBN) ownership, utilization and factors influencing ownership and utilization was recorded.ResultsA total of 443 respondents were recruited and 208 (47.0%) possessed at least one MBN (total = 275 MBNs) with a median of 1.33 nets. Of the 275 nets found in households, 89 (32%) were potent ITNs and others had never been retreated/treated. Purchase of MBNs from the market was associated with marital status (P = 0.010) and urban settlement (P = 0.045). The number of respondents who did not know where to retreat/treat ITNs was significantly higher (P = 0.005) in urban than rural dwellers. The proportion of rural respondents who had once taken their MBNs for re-treatment was significantly higher (P = 0.002) than that of urban dwellers. MBN utilisation was 69.7% (95% confidence interval; CI = .63.2–75.6%). A total of 83.4%, 13.8% and 3.4% used MBNs throughout the year, during the rainy and dry seasons respectively. MBN use in children under five was associated with being from an urban area (P = 0.01). MBN use in pregnant women was associated with living in block-louver houses than in block-pane houses (P = 0.047).ConclusionsUtilization of MBN needs to be encouraged to match ownership while free distribution of ITNs to vulnerable groups needs to be continuous and consistent.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-624) contains supplementary material, which is available to authorized users.