Background: Anaemia in pregnancy remains a pressing public health concern in low- and middle-income countries. This study assessed the prevalence, morphological classification, and associated risk factors of anaemia among pregnant women attending antenatal care at Korle Bu Teaching Hospital, Ghana. Methods: A cross-sectional study was conducted involving 297 pregnant women. Sociodemographic, clinical, and dietary data were collected using structured questionnaires. Haematological parameters were analyzed to classify anaemia morphologically. Associations between anaemia and various risk factors were explored using logistic regression. Results: The prevalence of anaemia was 47.8%, with normocytic normochromic anaemia being the most common type (62.7%), followed by microcytic hypochromic (34.5%) and macrocytic anaemia (2.8%). Anaemia was significantly associated with the second trimester, short interpregnancy intervals (≤2 years), self-reported infections, poor knowledge about anaemia, physically strenuous work, and inadequate folate supplementation. Folic acid use was protective, reducing the odds of anaemia by 72%. While most participants had inadequate intake of iron- and vitamin-rich foods, only folate deficiency was significantly linked to anaemia risk. Morphological patterns revealed that microcytic hypochromic anaemia correlated more with nutritional deficiencies, while normocytic anaemia was associated with infections and gestational stage. Conclusion: Anaemia in pregnancy at this tertiary facility is common, with multifactorial causes involving infections, short birth spacing, poor nutritional status, and inadequate supplementation. Targeted interventions including early antenatal care, nutritional support, infection prevention, and education on anaemia risks are essential to mitigate its burden.