To determine the prevalence and factors associated with dental anxiety among pregnant women seeking care at the Preventive Oral Health Unit, Institute of Oral Health, Maharagama, Sri Lanka. The participants of this descriptive cross-sectional study were 402 pregnant women seeking care at the Institute of Oral Health, Maharagama for the first time. A validated Sri Lankan version of the Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety and an interviewer-administered questionnaire collected information about demographics, dental service utilization, knowledge, and the importance of oral health during pregnancy. The prevalence of dental anxiety was 61.7% and the mean MDAS score in the dentally anxious and not anxious were 13.4±3.8 and 9.20 ± 1.7 respectively. According to the binary multiple logistic regression model current employment status, household income, dental care seeking pattern, having had a negative experience during a previous visit to a dentist,poor awareness about the importance of oral health in pregnancy, not receiving oral health instructions from health care providers during pregnancy, the perception that oral care should be avoided during pregnancy were independently associated with dental anxiety. The prevalence of dental anxiety was high among this sample of pregnant women.