Introduction One of the most effective ways to prevent malaria prevention is sleeping under an insecticide treated bed net. In Ethiopia insecticide treated bed net intervention as one of the most malaria prevention strategy is being practiced. Insecticide treated bed net intervention in Dera district started in 2006 and currently 95% were accessed but utilization was not well known. Objective:- To determine the magnitude of utilization of Insecticide Treated Net and identify Associated Factors among Pregnant Women in Dera district, North-West Ethiopia,2021. Methods. A community based-cross-sectional study was conducted in Dera district and the study subjects were selected by multi stage sampling techniques. To select the participants, health post pregnant registration book was used as sampling frame. A total of 591 pregnant women’s were included in the study. Data was entered through EPidata 4.6 and exported to SPSS Version 23 for further analysis. Binary logistic regression were used to identify the potential determinants. P-value and 95% confidence interval was used to measure the level of significance on multi-variable analysis. Results: Among 570 pregnant women surveyed, utilization of Insecticide Treated Net in pregnant women’s were 38.2% (95%,CI : 34.2,42.1) .Responses rate of respondents were 96.6% and the mean age of respondents was 30.27 years with SD 14.6 years. Educational status (AOR=1.96; 95% CI : 1.04,3.67) , member of community based health insurance (AOR=0.45; 95% CI: 0.22, 0.90) and Antenatal care visit(AOR=3.18;95% CI : 1.03,9.8) were statically significance variables for Insecticide Treated Net utilization among pregnant women. Conclusion& Recommendation: Utilization of insecticidal net was low as compared with previous evidence, and Antenatal care visit, educational status and member ship of community based health insurance were the factors associated with insecticidal net utilization. Formal educational status, respondents who were membership of community based health insurance were good utilization of Insecticide Treated Net , therefore, to increase Insecticide Treated Net utilization, conclude that strengthen female educational level, Antenatal care follow up with service counseling and member of community based health insurance .