In Kenya, one of the strategies to control malaria during pregnancy is through the use of intermittent preventive treatment of malaria in pregnancy (IPTp) and insecticide-treated bed nets (ITNs) in conjunction with other intervention methods. But the uptake of these services among pregnant women is not fully optimized. The study assessed the knowledge on malaria and determined factors associated with utilization of malaria preventive and control measures among pregnant women in Kisumu City.  Method A descriptive cross sectional study design was used during the survey, it was a one-point survey and the participants were met only once with no follow up done. A random sampling technic was employed and quantitative data collection method used. The method allowed the investigator to measure disease knowledge of the study participants and determined economic and demographic factors associated with utilization of malaria preventive and control measures among pregnant women in the study area. A total of 349 pregnant women aged between aged 14-49 years, with viable pregnancy (any gravidae) who had stayed in the study area for the last six months, attended ANC at Kisumu County Referral Hospital (KCRH) were enrolled in the study in the study. A structured questionnaire was used to collect data on knowledge level on malaria disease, social - economic and demographic factors that were associated with utilization of malaria prevention and control measures among pregnant women. Sample size was calculated based on malaria prevalence of 28% in the study area. Binary logistic regression, chi square and multivariate analysis (p p<0.05 ) were used to determine if there was any association for the categorical vairiables with utilization of malaria preventive and control measures among pregnant women.  Results The finding reported knowledge levels about signs and sysmptoms of malaria was at 95.42%, malaria transmission at 90.54%, impact of malaria at 65.04%, malaria intervention methods at 89.68% and IPTp was at 57.59%. The main factors associated with utilization of malaria preventive and control measures among pregnant women were knowledge of malaria intervention methods (AOR 3.16, 95% C.1 1.38- 7.21,p=0.006), knowledge of IPTp as malaria preventive method (AOR=4.55,95% CI=2.44-8.p=0.001), permanent employment and employment (AOR 2.08, 95% C.I,1.12-3.84, p=0.02). In this study, participants education was not stastistically significant.  Conclusion The data from this study has shown risk of malaria in pregnant women within Kisumu city is high. The findings reported knowledge on disease transmission, signs and symptoms, sources of information and complications involved during pregnancy affected utilization of malaria preventive and control measures by the respondents. A bigger proportion of the respondents had knowledge on malaria intervention methods but use of IPTp as malaria intervention method was low. However, knowledge and use of Coartem® as antimalarial was high by the respondents. The finding also reported that socioeconomic factors influenced the utilization of malaria preventive and measures by the respondents. Demographic factors of the participants influenced utilization of malaria preventive and control measures by the respondents.