This was a cross sectional, descriptive study designed to assess the knowledge, attitudes and practices (KAP) of pregnant women concerning the use of insecticide treated bed nets (ITNs) in Anambra state, South-East Nigeria. A well structured questionnaire was self administered to 700 volunteer pregnant women aged 17-45 years, recruited during routine antenatal visits in randomly selected hospitals in the study area, between January 2012 and March 2013, to extract information on biodata and use or non use of ITNs. The information obtained was analyzed using simple ratios, percentages and charts. The results showed that out of 700 respondents, 651 (93%) knew about ITNs, 420 (60%) owned nets out of which 235 (56%) refused to use ITNs. The reasons for refusal to use ITNs were as follows: excessive heat (40.3%), inadequate accommodation to hang nets (13.3%), house was netted (11.7%), ITNs do not work (3.7%), net caused itching (o.7%), heard ITNs killed someone (1.7%), does not like ITNs (4%), no reason at all (24%). The study concludes that whereas the women’s knowledge about ITNs was good, the attitudes and practices were poor. Health education and mass literacy campaign can reverse the ugly trend.