The impact of malaria in pregnancy amongst women attending ante natal care in hospitals within Imo State Nigeria was studied, A total of 3000 pregnant women were initially recruited for the study, 2,871 (95.7%) gave full consent and consequently participated in the study. One hundred and twenty nine (4.3%) others did not complete their questionnaires properly or did not donate blood samples for laboratory investigation. Out of 2,871 persons examined using the Quantitative Buffy Coat (QBC) method 2,323 (80.9%) had malaria parasites. Similarly, the direct stained smear technique showed that 2,301 (80.1%) persons had malaria parasites while the Plasmodium falciparium (pf) antigen test showed that 1,801 (62.7%) persons were positive for malaria due to Plasmodium falciparium.Comparatively, the QBC and slide smear techniques were more effective for parasite detection than the pf antigen test. The age related prevalence showed that pregnant women within the age bracket 18 - 25 years had the highest prevalence (86.1%) of malaria infection, followed by those in the 36 - 40 (82.8%). The least prevalent age group was the 40 years and above group (74.7%) The overall mean infection according to zones showed that Owerri had the highest prevalence (83.9%), followed by Okigwe (72.1%) and Orlu (66.9%). Statistical analysis of the data showed a significant difference (p < 0.05) in the prevalence of plasmodiasis between the three zones of Imo State. Many pregnant women lost their jobs, some could not attend fully their businesses, some missed their religious activities due to malaria in pregnancy. Some women had low birth weight babies, some pre - term delivery etc due to malaria in pregnancy. This study has shown that malaria is a major public health challenge among pregnant women in Imo State Nigeria, leading to inestimable economic and social losses.