BACKGROUND: Malaria is still a health challenge in Sub-Saharan Africa. Its debilitating effect is felt the most by pregnant women and their unborn children. In tackling this menace, the use of sulphadoxine-pyrimethamine (SP) for intermittent preventive therapy (IPT) is one of the three approaches recommended by the World Health Organization (WHO) for preventing malaria in pregnancy (MiP). Unfortunately, parasite resistance which is caused by accumulation of mutations at the dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes of the malaria parasite is threatening the effectiveness of the medication. AIM: To describe patternof plasmodium falciparum resistant markers to sulphadoxinepyrimethamine and associated fetomaternal outcomes among pregnant women with malaria parasitaemia. METHODOLOGY: This was a cross-sectional study. Pregnant women at the study centers were screened for malaria parasitemia withrapid diagnostic test kits, thick and thin blood film for microscopy, and DNA analysis using PCR during the antenatal clinic. Women between 28 and 40 weeks gestational agewith malaria parasitaemia were recruited for the study. Gestational age at delivery and birth weight was obtained from the delivery records. Data were entered into SPSS version 22.0 (California USA). Bivariate analysis of categorical variables was done using the Chisquare or Fisher exact test as appropriate. The significance level was set at p= 0.05