Background: Malaria is one of the major health problems of therncommunity in the world, mainly to children and pregnant women. The usernof insecticide treated nets (ITNs) for protection against malarial is one ofrnthe major strategies currently applied in most developing countries. Raya-rnAzebo is one of the target Districts in Ethiopia for ITNs intervention, butrnwith limited evidences pertaining to its possession and utilization in thernmost vulnerable group like pregnant women.rnObjective: To assess the status of ITNs possession, utilization andrndeterminant factors among pregnant women for malaria control.rnMethodology: A cross-sectional study was conducted in both urban andrnrural areas of Raya-Azebo District in Tigray Regional State. Usingrnmultistage stratified sampling method, 815 households with at least onernpregnant woman were interviewed from randomly selected 21 Kushetsrnfrom rural areas (90.6% pregnant women) and three Kushets from urbanrn(9.4% pregnant women).The interview were regarding to possession andrnutilization of ITNs by the pregnant women. Four Focus Group Discussionsrn(FGDs) were also held to generate important ideas for the study. Inrnaddition to this, direct observation about the proper utilization of ITNs byrnthe pregnant women and children under-five was carried out during earlyrnmorning. Data entry and analysis were done using SPSS version 10 softrnware.rnResult: ITNs possession and utilization of during the preceding night byrnpregnant women of the study area was 59% and 34.5%, respectively. Netrnre-impregnation rate in the areas was 96%. Educational status of thernpregnant women, lack of radio at household level, gravidity, family sizernand number of living rooms were the most important factors thatrninfluenced possession and utilization of ITNs.rnvirnConclusions: Possession and utilization of ITNs by the study householdsrnwere low. Educational level, radio possession, gravidity, family size, lackrnof access to ITNs, and way of distribution were the main determinants forrnpossession and utilizations of ITNs. Improving the availability, sustainablernintegrating of the supply of ITNs to ant natal care (ANC) services and alsornto other sectors can be assured. Effective Information, Education andrnCommunication (IEC) should be needed to enhance continuous uses ofrnITNs for protection of malaria in the highly risk group of the community.