Intimate partner Violence (IPV) can affect any woman, irrespective of their economic status, religion, or culture. This is a human-rights issue and due to its prevalence and adverse effects on pregnancy and birth, it must be given greater attention. Further, there is a lack of data in the Tigray region about adverse birth outcomes due to intimate partner violence during pregnancy. The aim of this study was to assess intimate partner violence during pregnancy and its association with low birth weight and preterm birth in Tigray region. Across-sectional study design was used. 647 women were involved in the study. Simple random sampling techniques were employed to select health facilities and systematic sampling was used to select study participants. Data were entered using Epi info version 3.5.1 and was analyzed using SPSSversion 20. Logistic regression analysis was conducted to assess the association between exposure to intimate partner violence during pregnancy and preterm birth and low birth weight while adjusting for possible confounders. The prevalence of intimate partner violence during pregnancy was 7.3% and the prevalence of low birth weight and preterm birth were 18.5% and 10.8% respectively. There was a statistically significant association between exposure to intimate partner violence during pregnancy and low birth weight. After adjustment for socioeconomic status, women's habits and obstetric factors, the pregnant women who were exposed to intimate partner violence during pregnancy were two times more likely to have a child with a low birth weight (2.39 (95% CI: 1.26-4.55)). The prevalence of intimate partner violence during pregnancy, low birth weight, and preterm birth in this study was high. Women who experienced intimate partner violence during pregnancy had an increased risk of low birth weight. These findings justify a call to the federal minster of health to take measures aimed at avoiding intimate partner violence during pregnancy to reduce adverse birth outcomes.