Background: National surveys indicate that among countries in Africa where malaria is endemic, Nigeria alone accounts for 21% of pregnancies that are unprotected from malaria. The purpose of this study is to ascertain the extent of utilization and effectiveness of malaria prevention methods, to find out the existing relationship between maternal parasitaemia and the effectiveness of these methods at (p<0.05) level of significance.Methods: The study was a cross sectional survey involving 264 consenting booked pregnant women who were recruited from antenatal clinic at Federal Teaching Hospital, Ido -Ekiti, Ekiti State, Southwestern Nigerian. Interviewer administered questionnaire was used to elicit information on the socio-demographic characteristics of the respondents, mode of malaria prevention, extent of utilization of malaria prevention methods and their effectiveness. Venous blood samples for malaria parasite test were collected and microscopic analysis was done to detect the malaria parasite in the obtained blood samples. Data was analyzed using SPSS version 20.0Results: All the 264 pregnant women interviewed, consented to having their blood taken. In rank order, the mode of malaria prevention methods most commonly reported as being effective were Intermittent Preventive Treatment using sulphadoxine-pyrimethamine (IPT-sp) which was favored by majority 190 (72.0%). This was followed by Insecticide Spray 166 (62.9%). Insecticide Treated Nets (ITNs) were the least utilized by 108 (40.9%) respondents. Nine (8.3%) of the 108 participants that used ITNs, 15 (7.9%) of the 190 participants that used IPT-s and 18 (10.8%) of the 156 participants that used Insecticide Spray tested positive for malaria respectively. There was a statistically significant association between maternal parasitaemia and malaria prevention methods using ITNs (p=0.001), IPT-sp (p = 0.001) and Insecticide sprays (p = 0.001).Conclusion: The three malaria preventive methods adopted for this study were ITNs, IPT-sp and Insecticide Spray. Despite their protective effectiveness, their utilizations are still poor. Information and communication strategies with other concerted efforts by the stakeholders are suggested to ensure proper implementation of the national policy on malaria as adopted by other countries.