To assess anaemia prevalence and correlated social and biological determinants among pregnant women in the Occupied Palestinian Territory (oPt).

A cross-sectional survey conducted among pregnant women attending/accessing UNRWA (United Nations Relief and Works Agency for Palestine Refugees in the Near East) health centres in the Gaza Strip and the West Bank in September and October 2006.

Fifty-five UNRWA health centres in the oPt (eighteen in the Gaza Strip and thirty-seven in the West Bank).

A random sample of 1740 pregnant women.

Overall anaemia prevalence was 38·6 % (95 % CI 36·3, 40·9 %). A substantial difference in anaemia prevalence was observed between the Gaza Strip and the West Bank (44·9 % v. 31·1 %, respectively), as well as a significant increase in anaemia prevalence in the Gaza Strip compared with an Agency-wide survey conducted in 2004 (44·9 % v. 35·7 %, respectively). Anaemia prevalence was found to increase with age, parity and trimester of gestation.

Anaemia still appears to be a public health problem among pregnant women in spite of UNRWA interventions. The West Bank shows prevalence rates similar to those observed in neighbouring countries, while the Gaza Strip has higher rates. Prevalence rates of anaemia among pregnant Palestinian women are more than two times higher than those observed in Europe.