BACKGROUND: Malaria in pregnancy is a major public health problem and a significant contributor to maternal and perinatal morbidity and mortality. Sulphadoxinepyrimethamine (SP) is currently the only drug recommended for intermittent preventive treatment of malaria during pregnancy (IPTp). The absence of an alternative drug for individuals that are allergic to SP and the emergence of resistance to SP threatens the gains made by intermittent preventive treatment of malaria during pregnancy using sulphadoxine-pyrimethamine (IPTp-SP). Dihydroartemisinin-piperaquine (DHA-PPQ) is a safe, well-tolerated artemisinin-based combination drug that is effective in the treatment of malaria and has a long-lasting post-treatment prophylactic property. These qualities make DHA-PPQ a good candidate to be evaluated for IPTp. AIMS: This study compared the efficacy of sulphadoxine-pyrimethamine and dihydroartemisinin-piperaquine in the intermittent preventive treatment of malaria during pregnancy. MATERIALS AND METHOD: This was an open-label randomized controlled trial that involved a total of 320 pregnant women that presented to the Federal Teaching Hospital Abakaliki Ebonyi state for antenatal care and delivery. Data was collated, tabulated and then analysed with the Statistical Package for Social Science (IBM SPSS) software (version 20, Chicago IL, USA).