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Abstract Objective This study was done to determine the patterns of Candida spp. causing vaginitis and associated factors among pregnant women attending antennal clinic in Mwanza, Tanzania. Results A total of 197 (65.6%) out of 300 non-repetitive swabs had positive growth of Candida spp. Candida albicans 125 (63.4%) was the most predominant isolated specie followed by C. tropicalis 35 (17.8%) and C. glabrata 33 (16.8%). Laboratory confirmed candida vaginitis was independently predicted by douching practices (OR 3.2, 95% CI 1.3–7.5 P = 0.007), history of antibiotics use (OR 1.8, 95% CI 1.02–3.0, P = 0.04) and low social economic status (OR 2.04, 95% CI 1.1–3.7 P = 0.02). About two-third of pregnant women with clinical features of vaginitis attending antenatal clinic in Mwanza, Tanzania were confirmed to have Candida vaginitis mainly caused by Candida albicans.