To determine the prevalence of prenatal depression and explore its association with socio-demographic risk factors, stressful life events and women autonomy/decision-making. The recognition of these problems would play a substantial role in the strategic development of interventions for those Pakistani women who have been suffering from prenatal depression. Analytical cross-sectional study conducted in Allied hospital Faisalabad during a period of 18 months (1st Jan 2019 to 30 June 2020). Data was collected by using simple random sampling technique. EPDS was used to measure prenatal depression. A modified kuppuswamy scale, Life Events and Difficulties Schedule (LEDS) and women autonomy/decision making scale was used to assess the risk factors. A total of 380 women were included in the study. The mean age (in years) ± SD was 29.37±5.27. According to cut-off score >10 on Edinburg postnatal depression scale the prevalence of depression was found as 51.6%. The findings revealed that women education, socio-economic class, BMI, pregnancy duration, history of miscarriage, contraception, stressful life events and women autonomy had significant association with prenatal depression (P<0.05). Socio-demographic factors, stressful life events in previous life and women autonomy are significant predictors of prenatal depression that need to be addressed in order to sustain safe motherhood.