Infection with Hepatitis B virus continues to be an important global public health problem with millions of people worldwide affected. Around 2 billion people have been exposed to hepatitis B globally, and about 257 million people are living with hepatitis B particularly in the Low and Middle-income countries. Cameroon is endemic and pregnant women are rarely screened routinely in most health facilities in Cameroon. The objective of this study was to determine the prevalence, knowledge and risk factors of hepatitis B among pregnant women in Loum Health District. This study was a cross sectional hospital and community-based carried out among pregnant women in the Loum Health District. All the 5 health areas and 24 health facilities were included. Data on the socio demography and knowledge on hepatitis B infection was collected using a structured questionnaire. Pregnant women were screened for hepatitis B surface antigens (HBsAg) using the DiaSpot One Step Hepatitis B test. Data was analyzed using SPSS version 26. The Chi square test was used to compare proportions and the logistic regression model was fitted to find out factors independently associated with knowledge, prevalence and attitude. Of the 200 pregnant women screened, 18 (9%) were positive for hepatitis B virus. Higher prevalence was observed for the age group 16-25 (10.8%) and primary level of education 7 (13.5%). The results showed that pregnant women had inadequate knowledge on HBV infection. History of multiple sex partners (AOR=5.58, P=0.001), history of surgery (AOR=3.04, P=0.026) and history of tattooing (AOR=2.36, P=0.041) were all significantly associated with hepatitis B sero-positivity. The prevalence of HBsAg was 9% with only one third of participants having adequate knowledge on Hepatitis B. Although hepatitis B is recognized to be one of the major health problems, pregnant women in the Loum health district were less aware of its mode of transmission, consequences and prevention. History of surgery, tattooing, multiple sexual partners were factors that increase hepatitis transmission. Compulsory screening of pregnant women in hospital and health educative talks on Hepatitis B during antenatal visit could create more awareness among pregnant women.