Abstract Background. Despite advancements in modern healthcare and health delivery systems, the use of Herbal medicine among pregnant women remains increasingly prevalent in many parts of Sub-Saharan Africa, including Uganda and western Uganda. Herbal medicine is often perceived as affordable, culturally acceptable, and accessible. However, its use during pregnancy raises safety concerns for both mother and fetus. This study assessed the prevalence and factors associated with Herbal medicine use among pregnant mothers attending antenatal care at Mbarara City Health Centre IV. Methodology; A cross-sectional descriptive study using researcher-administered questionnaires was conducted among 359 pregnant women. Data were analyzed using SPSS with both descriptive and inferential statistics. Results: The prevalence of Herbal medicine usewas 60.1%, with most usage occurring in the first trimester and mainly administered orally. Significant associated factors included age, marital status, antenatal care attendance, and cultural beliefs. Further results show that the majority of participants who used Herbal medicine used it orally, which totals up to 158participants making 43% of the participants who used Herbal medicine; the others, totaling up to 36participants used Herbal medicine topically, making 10% of the participants who used Herbal medicine, while 7.5% used Herbal medicine both orally and topically among the participants who used Herbal medicine, a bigger percentage used it during first trimester, totaling up to 100participants which accounts for 32.4% of the participants, followed by 81, which is 22.4%, who used it in second trimester and 2(5.8%) who used it in the third trimester Conclusion; The Study Concluded that Herbal Medicine useis Influenced by Cultural Norms, Perceived Safety, and Communication Gaps with Healthcare Providers. Health Education Interventions.

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