Objective Anaemia during pregnancy is higher in developing countries like India and associated with an increased risk to maternal health and outcomes. The present study estimates the prevalence and determinant risk factors of anaemia among pregnant women in India. Design Cross-sectional Setting Data from a nationally representative household survey of National Family Health Survey-5 conducted during 2019-21. Population A total of 27,317 currently pregnant women with anaemia status. Methods Estimating the prevalence differences and risk factors using descriptive statistics and multinomial logistic regression. Main outcome measures Anaemia Results About 52.2% of pregnant women in India were anaemic and prevalence was higher among women with no education (59.2%), belonging to poorest wealth quintile (61.9%), and scheduled tribes (59.3%) compared to their counterparts. The socio-economic determinant factors for severe anaemia were no education (aOR 4.07, 95% CI 3.40-4.86), poorest wealth quintile (aOR 2.05, 95% CI 1.73-2.43), and no exposure to media (aOR 2.11, 95% CI 1.70-2.60) than their counterparts. Women who were vegetarian (aOR 1.78, 95% CI 1.64-1.93), had previous abortion (aOR 1.97, 95% CI 1.58-2.47) and stillbirth (aOR 2.09, 95% CI 1.66-2.64) are more likely to have severe anaemia than non-vegetarian, and those in first pregnancy. Among women with gestation of ≤20 weeks, underweight were more likely to have severe anaemia (aOR 1.60, 95% CI 1.44-1.79). Conclusion Different geographical, socio-economic and clinical factors influence high prevalence and severity of anaemia among pregnant Indian women. Social norms-based interventions and strengthening the community health facilitators may help to combat high burden of anaemia.