Background: Antenatal depression is a significant concern worldwide, particularly in low- and middle-income countries where prevalence rates vary widely. Understanding the socio-demographic and medical factors associated with antenatal depression is crucial for effective intervention and management. This study aims to assess the prevalence of antenatal depression and its relationship with various demographic, obstetric, and medical factors among pregnant women attending a tertiary healthcare hospital in Bhopal, India. Methods: An observational cross-sectional study was conducted over 18 months, involving 500 pregnant women attending antenatal clinics. Participants were assessed using a structured questionnaire covering demographic, obstetric, and medical factors. Antenatal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed to determine associations between depression and various factors. Results: The prevalence of antenatal depression was found to be 28.4%. Significant associations were observed between depression and socio-demographic factors such as younger age, lower education levels, lower socio-economic status, and belonging to extended or joint families. Medical factors such as stage of pregnancy, parity, marital conflict, unplanned pregnancy, preference for a male child, and past history of abortion were also significantly associated with antenatal depression. Conclusion: This study highlights the high prevalence of antenatal depression among pregnant women and identifies several socio-demographic and medical factors associated with its occurrence. Effective screening and management of antenatal depression, particularly among women with lower education levels, poorer socio-economic status, and limited family support, are essential for improving maternal and child health outcomes. [ABSTRACT FROM AUTHOR]