Background: Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in India. Yet the use of EC is very low and abortion rate in cities is high. Objective: To assess the practice and determinants of use of emergency contraceptive pills among women presenting for pregnancy termination in a tertiary care hospital. Material and Methods: This was a Cross-sectional, hospital-based study, conducted among the women of reproductive age group presenting for termination of pregnancy in a tertiary care hospital in Western Maharashtra. The study was conducted for a period of three months from May to July, 2016. Data was collected with the help of a preformed and prestructured questionnaire. A total of 150 cases were enrolled in the study. The data was tabulated and analyzed using Epi Info and MS Excel. Result: The knowledge of emergency contraception was seen in 34.0% subjects, out of which only 7.3% had good knowledge. Attitude wise assessment of emergency contraception showed that 74.7% subjects had favourable attitude towards its use while only 21% participants used emergency contraceptive pills. The study revealed that there is a low trend of use of modern contraceptives. The major reason for low usage was lack of adequate knowledge on the method, misperceptions of the adverse effects of this method, fear of effect on future fertility. Factors like women belonging to urban area, education, socioeconomic status and knowledge of contraception and emergency contraception and ever used contraceptive were the significant determinants of EC use. Conclusion: It is concluded that knowledge and use of emergency contraceptive is low while all had favourable attitude towards its use. Awareness is to be created among the community through information, education and communication so that the its use will be increased.