<p>Even though maternal hypertensive disorders (MHDs) is the second cause of maternal death in Ethiopia, detail and population based study among pregnant women is lacking in the study area. Hence, this study had assesed the prevalence of MHDs and associated risk factors among pregnant women, in North Central Ethiopia, 2023. A community-based cross-sectional study was conducted using the WHO STEPWISE questionnaire among 855 participants through multi-stage cluster sampling in five districts of North Central Ethiopia from May to June 2023. Binary and multivariable logistic regression analyses were performed, and a P-value of &lt; 0.05 was used to declare statistical significance. Seven percent (95% CI 6%, 8%) of pregnant women had MHDs. Pregnant women who had no history of hypertension had 52% lower odds (adjusted odds ratio (AOR = 0.48, 95% CI 0.44, 0.52) than those with a history of hypertension. Pregnant women, who ate processed food that are high in salt sometimes and rarely had 88% and 81% less odds (AOR = 0.12, 95% CI 0.03, 0.47), (AOR = 0.19, 95% CI 0.07, 0.55) than those who ate always, respectively. Women who didn’t know to express blood pressure measurement had 56% lower odds (AOR = 0.44, 95% CI 0.22, 0.89) of maternal hypertensive disorders than those who expressed the measurement. Seven out of hundred pregnant women had MHDs. Previous history of hypertension, women knew how to express their blood pressure measurement and consumed processed foods high in salt rarely and sometimes were factors strongly associated with MHDs. Zonal health departments and their partners should strengthen advocacy for prevention and control of MHDs in the study area.</p>