Background Anaemia in pregnancy is defined as haemoglobin concentration less than 11.0 g/dl. Globally, anaemia affects half a billion women of reproductive age. Anaemia during pregnancy is a public health problem especially in developing countries and is associated with adverse outcomes in pregnancy Objective To study the prevalence, risk factors and management of anemia with Pregnancy among women attending antenatal care clinic in Wad Madani Teaching Hospital (October 2021 to March 2022). MethodsAprospective descriptive cross sectional hospital based study was conducted in Wad Medani Teaching Hospital ANC clinic during the period from October 2021 to March 2022 and covered all pregnant women in antenatal period . Data collected, prepared, entered and analyzed using SPSS version 25.0. Results This study covered 353 participants (pregnant women). Concerning the anaemia characteristics, the study showed that the prevalence of anaemia was 162 (45.9%), and 11 (6.8%) had severe anaemia, 42 (25.9%) moderate, and 109 (67.3%) mild anaemia. All anaemic patients received a dietary intake correction advice, 79 (48.8%) iron supplementation and only 10 (6.2%) received blood transfusion. The analysis found that the prevalence of anaemia was significantly higher among pregnant women with extreme ages (less 20 years and above 40 years), lower education, rural residence, higher parity, third trimester, irregular antenatal care visits, and with positive history of anaemia with p values < 0.05. Conclusion and recommendationOur study concludes that the occurrence of anemia among pregnant women is high and should not be ignored, and the associated factors must be taken into consideration, to improve the prevention and management policies of this serious problem among pregnant women in Sudan.