Aim:This study aimed to compare the efficacy and safety of intravenous iron sucrose and ferric carboxymaltose in managing iron deficiency anemia (IDA) in pregnant women. Materials and Methods:A prospective, randomized, open-label trial was conducted with 140 pregnant women diagnosed with IDA, aged 18 to 40 years, and with gestational ages between 14 and 34 weeks. Participants were randomly assigned to two groups: Group A (iron sucrose) and Group B (ferric carboxymaltose), each comprising 70 participants. Baseline hematological parameters, including hemoglobin and serum ferritin levels, were recorded. Group A received iron sucrose in multiple doses, while Group B received ferric carboxymaltose in fewer infusions. Hemoglobin and ferritin levels were reassessed at 2, 4, and 8 weeks post-treatment. Adverse reactions and maternal fatigue scores were also monitored. Results:Both groups had similar baseline characteristics. Group B showed a significantly greater increase in hemoglobin levels at 2, 4, and 8 weeks (p < 0.05 at all time points). Ferric carboxymaltose also resulted in higher serum ferritin levels, indicating better iron store replenishment (p < 0.05 at all follow-up points). Adverse reactions were slightly more frequent in the iron sucrose group (17.14% vs. 11.43%, p = 0.15). Fatigue scores decreased more significantly in Group B, suggesting improved maternal well-being (p = 0.02 at 8 weeks). Conclusion:Ferric carboxymaltose was more effective than iron sucrose in increasing hemoglobin and serum ferritin levels, reducing fatigue, and requiring fewer infusions. While both treatments were safe, ferric carboxymaltose provided a more efficient and convenient option for managing IDA in pregnancy, though cost and accessibility should be considered.