Introduction:NTDs are a heterogeneous group of CNS malformation resultingrnfrom faulty development of neural tube during one the three embryonic periods.rnNTD is the second most common congenital malformation following CHD and thernmost common form of CNS malformation. It encompasses a broad spectrum ofrnCNS malformation spanning from anencephaly which is incompatible with life tornminor occult malformation.rnNTDs have a global average incidence of 1.6 per 1000 live births, the highestrnincidence reported in Mexico and England. There is no adequate data on itsrnincidence in Ethiopia but its frequency ranges from 0.77-6.1 per 1000 live births inrnSouth Africa 1, 2, 3, 4&5.rnNTD is a multifactorial process resulting from interplay between genetic andrnenvironmental factors. There is an increased risk of NTD after affected siblingsrnand in siblings of affected parents1. There is also an increased risk in infants ofrnmothers with low serum folic acid level, poorly controlled insulin dependentrndiabetes millets, obesity and maternal intake of anti-epileptic and folic acidrnantagonist drug especially in the first trimester1, 11 & 12.rnObjective: to assess the point prevalence and the frequency of different types ofrnNTD using routine obstetric anatomic ultrasound scan as well as factorsrnassociated with NTDrnMethods: A hospital based trans cross sectional study was conducted in Ghandirnmemorial hospital on 84 pregnant women attending ANC from August 26 tornSeptember 10 of 2017. The study has included all pregnant women with arngestational age of 18 weeks and above and live pregnancy.rnResult: The study has included 84 pregnant women all of whom was singletonrnintra uterine pregnancies. The study participants had an average age of 27.5 yearsrnand literacy rate of 99% .The reported monthly average income was 3300 birr.rnNone of them took preconception folic acid supplementation while 71.4% tookrnduring first trimester. Thirty six point four percent took medically prescribedrnmedication during first trimester. Two of the fetuses had ananencephaly type ofrnNTD giving point prevalence of 23.8 NTD per 1000 pregnancies.rnviiirnConclusion: The literacy rate and participants living above the poverty line isrnmuch higher than both urban and national average. First trimester; especially,rnpreconception folic acid supplement intake is low in this study but the finding isrncomparable to similar studies. The point prevalence of NTD is significantly higherrnthan the global and regional averages. All of the studies calculated their incidencernas a ratio of live births and did not consider all forms of pregnancy losses and stillrnbirths. But it is difficult to generalize based on this study findings due to smallrnstudy population size and facility based study design. Further study isrnrecommended to assess knowledge, attitude and practice of reproductive agernwomen towards folic acid supplement intake. Large population based study isrnrecommended to assess the prevalence and the frequency of different types of NTD.