Severe anemia during pregnancy remains an acute maternal health problem in low income countries and its management is a challenge. This study aimed to analyze the characteristics of hospitalized pregnant women with severe anemia and issue of the management in a regional hospital of a low income country. Material and Methods: This was a retrospective descriptive study from January 1, 2007 to December 31, 2008, at a regional hospital maternity. Data of the 283 pregnancy severe anemia cases have been analyzed using usual Pearson’s Chi square test or Fisher’s exact test. Results: Of the 283 women with pregnancy severe anemia, 98% were illiterate, 98% were household women; majority were in the third trimester (64%); 41% had no previous delivery; 49% did not had antenatal care. There were no statistics association between hemoglobin values stage and gestational age, gravidity and parity. During the hospitalization, from the 283 women with pregnancy severe anemia, deliveries occurred on 22.6%; abortion on 1%. From the 64 deliveries, 45.3% were alive preterm birth, 20.3% preterm stillbirth, 25.0% at term birth and 9.4% at term stillbirth. Between the 45 alive babies, 91% were low birth weight. In global, from the 283 women, mortality rate was 2.8%. Conclusion: Severe anemia during pregnancy results in maternal mortality, preterm, low birth and stillbirth even between hospitalized women. As most of the pregnancy anemia risk factors are chronic poverty related factors, intervention must be focused on prevention including health pregnant women iron supplementation and adequate nutritional diet promoting at both health facilities and community level.