Background: Dietary diversity is an aspect of dietary quality that indicates general nutritional adequacy. Dietary diversity has important direct and/or indirect consequences for all age cohorts. The nutritional status of a woman during pregnancy is important as it impacts negatively on the health of the mother, the foetus and the newborn. The study aimed to assess the dietary diversity, the nutritional status and factors associated with nutritional status of pregnant women. Objective: The aim this study was to assess dietary diversity, Nutritional status and factors associated with nutritional status of pregnant women aged 15-49 years attending public health facilities in Yilimana Desna woreda, Northwest Ethiopia. Methods: Institutional based cross-sectional study was conducted among pregnant women who were at 1st, 2nd, 3rd and 4th ANC follow up in Yilimana Densa woreda attending public Health Facilities from March 26 to May 26, 2017. A sample of 421 participants was selected by using systematic random sampling technique. Data were collected using pre-tested interviewer administered structured questionnaire. The data were cleaned, coded, entered into EPI- INFO version 7.2.1 and transferred and analysed using SPSS version 23. Odds ratio was calculated with 95% CI to identify factors associated with Undernutrition. P-values less than 0.05 were considered as statistically significant. Result: The study revealed that the mean Dietary Diversity Score (DDS) was 1.62 ± 0.68 SD. In respect to nutritional status, 27.3% were undernourished based on Mid-Upper Arm Circumference (MUAC<23cm) while 34.3% were anaemic based on haemoglobin levels (Hgb<11g/dl). Factors like educational status (AOR=3.7; 95% CI 0.14-8.21; p=0.001), income category (AOR= 3.4 95% CI 0.04- 0.31; p=0.001), eating pattern (AOR=2.2 95% CI 0.12- 0.73; p=0.001), and dietary diversity (AOR=3.5 95% CI 0.39-1.46; p=0.000) were strongly associated with undernutritional status of pregnant women. Conclusion: Factors (educational status, monthly income, eating pattern and dietary diversity) has been influence nutritional status of pregnant women in this study. Policies and intervention programmes targeting these determinants of nutritional status should therefore be enacted, while the existing ones should be supported and monitored particularly among pregnant women.