Background:According to the World Health Organization (WHO), prevalence of anemia in developed and developing countries in pregnant women is 14% and 51%, respectively. IDA can cause various complications during pregnancy like increase susceptibility towards infection, reduce physical and mental functions, increase need of blood transfusion during delivery, cardiovascular complications, intra uterine growth retardation, preterm delivery, and perinatal mortality and morbidity.Iron sucrose (IS) and ferric carboxymaltose (FCM) are dextran free iron preparation for parenteral therapy. This study provides valuable insights into the efficacy and safety of Ferric Carboxymaltose (FCM) and Orofer. Understanding the comparative benefits of these therapies can help healthcare providers make informed decisions about the best treatment options for their patients. Aim & Objectives: To study the efficacy and safety of injectable iron therapy in treating iron deficiency anemia (IDA) during pregnancy, comparing Ferric Carboxymaltose (FCM) and Orofer and to compare their efficacy and safety. Material and Methods: A hospital based study was conducted among 200 antenatal anemicfemales who came between 12-24 weeks of gestation in Muzaffarnagar Medical College & Hospital, Muzaffarnagar, Uttar Pradesh. Study was conducted for 18 months.Data was analysed statistically. Results: Ferric Carboxymaltose (FCM) showed greater improvement in hemoglobin levels, mean corpuscular volume (MCV), and serum ferritin compared to Orofer in pregnant women with iron deficiency anemia. FCM patients saw hemoglobin increase from 8.62 ± 3.20 to 11.14 ± 12.51, while Orofer patients increased from 8.50 ± 4.75 to 9.29 ± 10.34. Serum ferritin levels significantly rose in the FCM group (32.27 ± 8.33 to 97.11 ± 12.37) but not in the Orofer group (29.25 ± 43.8 to 34.45 ± 76.56). Additionally, FCM had fewer side effects, making it a more effective and safer option for treating iron deficiency anemia in pregnancy. Most participants were aged 25-30 and were primarily in their first pregnancy. Severity of anemia varied, with 52% mild, 34% moderate, and 14% severe. Conclusion: Ferric Carboxymaltose (FCM) demonstrated greater efficacy and a more favorable safety profile compared to Orofer in treating iron deficiency anemia during pregnancy. These findings suggest that FCM may be a more effective and safer option for managing iron deficiency anemia in pregnant women.