Introduction: Medicine use during pregnancy is a growing trend in the world. Medicines easily rncross the placental barrier into the fetal body and are present also in the maternal milk. Exclusion rnof pregnant women from clinical trials has left questions about the safety of medicines in rnpregnancy. There were no such studies which assess the medicine use pattern and associated rnoutcomes among pregnant women in Butajira. Hence this study attempted to fill such gaps. rnObjective: To assess medicine use pattern and associated outcomes among pregnant women rnvisiting antenatal care unit in public health facilities in Butajira. rnMethods: Institution based prospective cohort study design was employed by interviewing rnpregnant women who were on routine antenatal care visit and waiting them until they give birth. rnStudy participants were waited from March, 2018-November, 2018. Interview included recent rnmedicine use history. Clinical data was obtained by abstracting the records of women who attended rnAntenatal Care follow up. rnResult: A total of 399 pregnant women were included in this study, of whom 382(95%) of them rnhad taken at least one medicine during pregnancy, and 24(6%) of them had self-medicated rnthemselves. From prescribed medicines for pregnant women, Iron with folic acid was the most rn(937, 71.5%) prescribed medicine while Zingeber officinale; ginger was the most (4, 36%) used rntraditional medicinal herbs used by the pregnant women. Medicines were prescribed from all FDA rnpregnancy risk categories. In this regard, from the total of medicines used by pregnant women, rn978(73.3%) were from FDA pregnancy category A, 194(14.5%) were from category B, 128(9.6%) rnwere from category C, 25(1.9%) were from category D, and 1(0.08%) were from FDA pregnancy rncategory X. rnFrom 377 study participants with outcomes of pregnancy (Apgar score, birth weight and term of rndelivery); 56(15%) had poor pregnancy outcomes while 321(85%) had good pregnancy outcomes. rnConclusion: The majority of the study population used safe and appropriate medications. rnHowever, though low, a limited number of pregnant women were exposed to medications with rnpotential risk for the fetus. Besides, although few, pregnant women reported the use of traditional rnmedicinal herbs for which pregnancy risk level was not assigned. No statistically significant rnassociation was observed between medicines used in this study and pregnancy outcomes.