Abstract Vitamin A plays important roles in vision, cellular differentiation, embryonic development, reproduction, growth, and the immune system. Women living in developing countries are at increased risk of undernutrition during pregnancy due to poverty, poor diet quality and quantity, and high fertility rate. Dietary quality and diversity reflect adequacy of vitamin A whereby reduce the risk of vitamin A deficiency. The aim of study was to determine adequacy of vitamin A among pregnant women attending antenatal care in health facilities of Dessie town, Ethiopia, January, 2017. Health facility-based cross-sectional study was conducted among 390 women that attended antenatal care in Dessie town. The 9 food groups from FAO based on 24hours dietary recall was used for data collection. Adequacy of vitamin A was determined from nutrient adequacy ratio after obtaining report of nutrient intake from food composition table version III and IV in terms of B carotene and retinol equivalent respectively, based on estimated average requirement recommendation of vitamin A, 370 RE/day for pregnant women. Multivariable Logistic regression analysis was done after dichotomizing the dependent variables. Adequacy of vitamin A among pregnant women was 41.8 % with an average nutrient adequacy ratio of 0.9. The mean dietary intake of vitamin A was 290.1μg per day. The predictors for adequacy of vitamin A were high and medium women diversity score (AOR= 2.92 ; CI: 1.50-5.70) and (AOR= 1.87 ; CI: 1.11- 3.16). In this study adequacy of vitamin A was low and affected by women dietary diversity score. Focusing on food based approaches especially educating pregnant women to diversify their diet is crucial to reduce their risk of vitamin a deficiency.