Background: Anaemia is a global public health problem which has an eminence impact on pregnant mother. The aim of thisstudy was to assess the prevalence and associated risk factor of maternal anemia.Method:A cross-sectional study design was conducted from April to May, 2014 on 286 pregnant women attending antenatal care in Nekemte Referral Hospital, Western Ethiopia. Hemoglobin level was determined by using HemoCue photometer, and interviewer administered questionnaire was used to collect associated risk factors. Data were cleaned, coded and fed into SPSS version 20.0 for analysis. Result:Among the 286 study participants, 29% were anaemic. Out of these majorities were mild types 72.20%. Pregnant woman who were HIV sero-reactive(Adjusted odds ratio (AOR)= 20.930, 95% CI =2.441-179.428), low family income(AOR= 17.384, 95% CI =3.757-80.443), having low dietary level (AOR =19.041, 95% CI=1.767-205.213) and body mass index (AOR =7.39, 95% CI=0.994-55.047), and infected with soil transmittedHelminth(STH)(AOR=33.555, 95% CI= 5.748-195.894) had higher odds of being anaemic with comparing to their counterpart but gestational age of first (AOR=0.07, 95% CI=.008-0.61) and second AOR =0.29, 95% CI= 0.09-0.918) trimester has lower odds of being anaemic when comparing to the third trimester. Conclusion:The prevalence of anemia was high; mild type anaemias were dominant. Low family income, having low dietary level and body mass index, STHand HIV infection were significantly associated with anemia. Antenatal care should promote de-worming, education on dietary practice and personal hygiene Therefor, there is a need to design strategies that help to diagnosis early and management of HIV and STHinfection during their antenatal care (ANC) visit instead of testing for only haemoglobin (Hgb) levels and bloodgroup.