ABSTRACT Background: Pregnant women in sub-Saharan Africa are highly vulnerable to malaria during pregnancy and are usually targeted to receive special preventive care for malaria using intermittent preventive treatment (IPT). Objectives: To determine the prevalence of malaria parasitaemia and uptake of IPT among pregnant Nigerian Igbo women. Materials and Methods: This cross-sectional study recruited 330 pregnant women from two public and private health facilities. Microscopy was used to determine prevalence of malaria in pregnancy while structured pretested questionnaire was used to determine the level of knowledge, and use of IPT among them. Data obtained were analyzed using SPSS version 25 software. Chi-square test was used for comparison of variables at p <0.05% level of significance. Results: Malaria prevalence was 18.5% and was highest for women of 20-24 years age range (24.3%). Knowledge of IPT was 76.7% while uptake was 58.8%. IPT uptake was highest amongst pregnant women aged 20-24 years (70.3%) and lowest amongst those aged 35-39years (50.0%). Compliance-knowledge index to IPT was significantly higher among the pregnant women with complete data (0.77) compared to the no response group (0.57), p=0.012. Pregnant women with tertiary educational qualifications had the highest level of compliance 60(61.2%) compared to secondary 120(58.5%) and primary 14(51.9%). Conclusion: Malaria parasitaemia occurred in 18.5% of the women. IPT knowledge and compliance were 76.7% and 57.7% respectively. Low Compliance-knowledge index amongst non-responders to question IPT compliance suggests ineffective malaria prevention awareness creation. The need to review malaria prevention awareness-creation strategies and encourage early ANC booking is recommended to improve IPT uptake.