Background: - Neural tube defect (NTD) is a structural defect of the central nervous system that affects the brain, spine and spinal column of the developing embryo during the first month of developmental process and most common congenital malformations, are potentially preventable cause of perinatal morbidity and mortality. Worldwide, around 10% of infant mortalities are due to nervous system defects. It is estimated that approximately 300,000 babies are born each year with NTDs worldwide. In Ethiopia there is very limited published data regarding the prevalence and associated risk factors as well as established preventive strategy of NTDs. Therefore, the purpose of this study was to assess the associated risk factor and prevalence of NTDs among pregnant outcome in Debreberhan Referral Hospital.rnObjective:- To assess the prevalence and risk factors of NTDs among pregnant outcome at DBRH, North Shewa, Ethiopia, 2019.rnMethods:- Hospital based unmatched case control study was conducted among 50 cases (neonate born with NTDs) and 100 controls (neonate born without NTDs) for associated risk factors and retrospective cross sectional, descriptive study of registration of all birth outcome for prevalence of NTDs were revised. The study was carried out at DBRH from August30/2017 to August 30/2019.rnThe data was checked for completeness and consistencies, and cleaned, coded and entered using Epi data version 4.2 and was exported to statistical package for social sciences (SPSS) software version 20 for analysis. Variables having P