Background: Iron deficiency anemia is the commonest type of nutritional anemia seen during pregnancy. Despite implementing oral iron prophylaxis in pregnancy, IDA in pregnant women constitute a major health problem. The present study aims to look at the prevalence of IDA in a pregnant population in Seremban, Malaysia and their response to treatment.Methods: This is a retrospective study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered between October 2019 to March 2020 in a state hospital in Seremban, Malaysia and their response to treatment. Main outcome measures were the prevalence of iron deficiency anaemia, associated demographic and clinical factors and response to iron therapy. Results: About 920 patients’ records were included for analysis. The prevalence of anaemia in this cohort was 42.8% (N=394).  The prevalence of iron deficiency anemia (IDA) was 31.5% (N=124) among the anemic patients or 13.5% of the studied population. The mean hemoglobin level for this group was 10.0±0.74 g/dl (6.8-10.9 g/dl) and majority had mild anemia (91.9%, N=114). 68.5% IDA patients were successfully treated by 36 weeks pregnancy. Of the remaining 39 patients who were still anemic, 37 (94.9%) had mild anemia with mean hemoglobin level of 10.3g/dl (SD 0.48, range 9.0-10.9 g/dl). Conclusion: Current treatment strategy is inadequate to achieve the set national target. There is a role for an early recourse to parenteral iron therapy to improve treatment outcome.