Each year, an estimated number of 300–500 million people are infected with malaria parasite, with an undesirable effect of over one million deaths. Pregnant women as well as young children, non-immune travellers visiting malaria-endemic zones are at the highest risk of suffering or experiencing life - threatening malaria infection. Maternal immunity, parasite density, parity, inadequate antenatal care services, drug misuse and abuse as well intermitted preventive treatment drug failure cum resistance are the most associated risk factors of malaria in pregnancy obtainable in endemic regions of sub-Saharan Africa. Identification and understanding of these factors will play a major role in reducing the burden as well as eliminating malaria disease among pregnant women living in endemic regions.