Abstract Iron deficiency anemia (IDA) remains a significant public health concern, particularly among pregnant women in developing countries, where nutritional deficiencies and healthcare access limitations contribute to high prevalence rates. This study examines the risk factors associated with iron deficiency anemia among pregnant women attending SOS Hospital in Baidoa, Somalia. The research explores medical, lifestyle, and socio-economic determinants influencing anemia during pregnancy. Using a cross-sectional study design, data was collected through structured questionnaires and interviews with pregnant women and healthcare providers. The findings indicate that poor dietary intake, frequent pregnancies, gastrointestinal disorders, and inadequate iron supplementation are key medical contributors to IDA. Socio-economic factors such as poverty, low educational levels, food insecurity, and limited access to healthcare services further exacerbate the condition. Additionally, lifestyle choices, including excessive tea or coffee consumption and heavy menstrual cycles, were identified as risk factors. The study underscores the urgent need for targeted interventions, including improved maternal nutrition programs, iron supplementation awareness campaigns, and strengthened healthcare policies to reduce the burden of IDA. Recommendations include integrating anemia screening into routine antenatal care, enhancing community education on proper dietary practices, and ensuring equitable access to healthcare services. These findings provide valuable insights for healthcare professionals, policymakers, and organizations working to improve maternal and child health in Somalia.