Anemia is a global public health problem. It affects more than 2 billion people worldwide, both in developing and developed countries. It affects people of all age groups. However, it is more prominent in pregnant women. It is estimated that approximately 41.8% of pregnant women worldwide affected by anemia. Institution based cross sectional study design was employed. A total of 424 pregnant women visiting public Health Institutions in Adama Town for Antenatal Care service was randomly selected. Data was collected using semi structured questioner and participants were interviewed at the exit of the Antenatal Care unit. Blood and stool sample was collected to determine the level of anemia and Middle Upper Arm Circumference measurement was measured to determine nutritional status of the mother. Data was entered into EPI-Info version 7 and imported into Statistical Package and Service Solution (SPSS) version 21 for data processing and analysis. Descriptive statistics were used to explore the characteristics of women and the magnitude of anemia. The association between the outcome variable (Anemia) and explanatory variable was analyzed using binary logistic regression. The effect of explanatory variable on Anemia was estimated using adjusted odds ratio (AOR) and 95% confidence interval was used for tests of significance. A total of 424 respondents participated in the study. The magnitude of Anemia was found to be 28.1% (P=28.1; 95% CI: 23.6, 32.1). The highest level of anemia 79 (37.3%) and 14 (31.1%) was observed among women of age 25 -34 years old and third trimester respectively. Birth interval of more than 2 years (AOR, 0.29; 95% CI: 0.13, 0.63), Nutritional status of MUAC < 23 cm (AOR, 8.91; 95% CI: 3.95, 20.11), taking tea (AOR, 5.49; 95% CI: 2.16, 13.96) and taking coca cola or chocolate (AOR, 6.81; 95% CI: 2.01, 23.12) and taking stimulant within 30 minutes after taking meal (AOR, 3.64; 96% CI: 1.47, 8.99) found to be significantly associated with the odds of having anemia during pregnancy. Magnitude of anemia is high (28.1%) among pregnant women in Adama Town. Respondents' birth interval, nutritional status, type of stimulant and time of stimulant taking were found to be significantly associated to anemia in pregnant women. Health works should work on counseling of benefits of lengthening birth interval and delaying of taking stimulants after taking their meals.