BACKGROUND: Many women persist in using traditional medicine despite the evidence that traditional medicines have the potential to harm both the unborn baby and the mother. Data on the extent of use of traditional medicine by women in Lesotho during pregnancy are largely unavailable. AIM: This study aimed to determine the prevalence of traditional medicine use during pregnancy among Basotho women and identify the associated factors. SETTING: The study took place in Ha-Shalabeng, Ha-Molengoane and Ha-Setoko, Lesotho. METHODS: A cross-sectional design was adopted, data were collected through a structured questionnaire, coded into Excel, and analysed using SPSS. Frequency distribution tables and graphs were used to describe the data on women. The χ2 test examined the association between categorical dependent and independent variables. RESULTS: The prevalence of traditional medicine use during pregnancy was 40%. The factors significantly influencing traditional medicine use, included age (p  0.01), educational level (p  0.01), location (p  0.01), transport availability (p  0.04), belief in the efficacy of traditional medicine (p  0.01), reasons for the type of care (p  0.01) and recommendations from parents (p  0.03). CONCLUSION: The utilisation of traditional medicine during pregnancy was found to be high. Therefore, it is crucial to have a policy in Lesotho that regulates the usage and safety of traditional medicine. Contribution: The data would be crucial in informing future research and shaping the development and implementation of traditional medicine policy, thus addressing the existing policy gap regarding traditional medicine in Lesotho.