BACKGROUND: High prevalence of anaemia has been reported among pregnant women especially in developing nations. This paper considers maternal haemoglobin (Hb) level, serum total iron, iron binding capacity, and serum ferritin in antenatal women in Orlu- Imo State Nigeria. PATIENTS AND METHODS: Haemoglobin level, serum iron, serum ferritin, and total iron binding capacity (TIBC) were measured in different trimesters among 90 pregnant women aged 20-45 years, on iron supplements attending antenatal clinic of Imo State University Teaching Hospital Orlu. First trimester comprised of 16.7% (n=15), second trimester comprised of 50% (n=45) while as third trimester comprised of 33.3% (n=30). 30 non-pregnant women aged 26-40 years were used as controls.RESULT: The mean Hb level was 11.28 ± 1.4 g/dl in first trimester, 9.5 ± 1.9g/dl in second trimester, 10.4 ± 1.2g/dl in third trimester, and 10.9 ± 1.5g/dl in controls. Mean serum iron level was 142 ± 23µg/ml in first trimester, 235 ± 118µg/ml in second trimester, 251 ± 118µg/ml in third trimester, and 99±19.4µg/ml in controls. Mean serum ferritin was 57.7 ± 30ng/ml in first trimester, 37.6 ± 17ng/ml in second trimester, 37.3±20ng/ml in third trimester, and 86.7±16.9ng/ml in controls. TIBC was 337±90 µg/dl in first trimester, 441±119µg/dl in second trimester, 482 ± 149µg/dl in third trimester and 271.8±89.0µg/ml in controls.Hb level was relatively stable in pregnancy, but was significantly (p<0.05) lowest in the second trimester compared with controls. Serum iron and TIBC progressively increased from first trimester to third trimester. Conversely, serum ferritin declined progressively from first trimester to third trimester. The increments in serum iron was statistically significant (p<0.05) between first and second trimester, but not significant between second and third trimester. TIBC was significantly higher in third trimester compared with first trimester. Serum ferritin was significantly lower in second and third trimesters compared with controls. This implies a progressive mineral transfer from mother to fetus. TIBC and serum iron were significantly (p<0.05) lowest in non-pregnant controls compared with the three trimesters of pregnancy. Conversely ferritin was significantly (p<0.05) higher among the non-pregnant controls compared with the three trimesters of pregnancy. This implies that the non-pregnant women had more iron store and had less iron need than their pregnant counterpart. The higher iron need in pregnancy necessitated its mobilization from its stores. CONCLUSION: This study encourages more critical antenatal care especially at second trimester of pregnancy with much emphasis on dietary supplementation of iron and minerals through adequate consumption of local vegetables and other food diets rich in iron. There was poorest antenatal attendance in the first trimester. Pregnant women in this environment should be encouraged to register early for antenatal care.KEYWORDS: Pregnancy, anaemia, Iron status