Background: Pre-eclampsia (PE) is one of the leading causes of maternal morbidity and mortality globally. Adequate knowledge about a disorder contributes greatly to its prevention, control and management. This study assessed the level of knowledge of PE and evaluated the factors associated with knowledge adequacy among pregnant women attending antenatal care at a University Hospital in Kumasi-Ghana. Methods: This cross-sectional study was conducted at the at a University Hospital in Kumasi, Ghana. A closed-ended validated well-structured questionnaire was used to collect socio-demographic information and history of PE. Knowledge of PE was assessed based on a series of questions regarding the awareness, signs/symptoms, risk factors and complications of PE. Responses were scored percentage-wise and grouped into low (<60%), moderate (60-80%) and high (80-100%). Knowledge score was then re-stratified into adequate (% score of ≥ 60%) and inadequate knowledge of PE (% score of < 60%). Results: The prevalence of inadequate and adequate knowledge of PE was 88.6% (mean score = 55.5 ± 4.3%) and 11.4% (mean score = 76.3 ± 5.9%), respectively. For participants with adequate knowledge of PE, 9.1% (mean score = 67.4 ± 6.9%) and 2.3% (mean score = 85.2 ± 5.1%) had moderate and high knowledge, respectively. Using univariate logistic regression models, being older (>35 years old) [cOR=3.09, 95%CI (0.88-10.88), p=0.049] and having a higher level of education (> SHS education) [cOR=4.45, 95%CI (2.18-9.10), p<0.0001] were significantly associated with greater odds of having adequate knowledge of PE. After controlling for potential confounders in multivariate logistic regression analysis, we found higher level of education to be independently associated with adequate knowledge of PE [aOR=2.87, 95%CI (1.31-6.30), p=0.008]. Conclusion: The knowledge of PE among pregnant women in Ghana is low. The prominent factor that facilitates adequacy of knowledge of PE is higher level of education.