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Background:  Birth preparedness is strategy to reduce MMR. It includes knowledge of key danger signs; identification of: birth place; birth attendant, fund, transport and compatible blood donor for emergency use. This study aims to explore birth preparedness in Surat and determine factors associated with it. Methods: Study conducted facility based cross-sectional study among 310 antenatal women at Urban Health Training Centre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretested questionnaire was used for data collection after informed written consent. Result: A total of 310 women participated in the study. Mean age of participants was 22.9+ 3.6 years. Almost one-third (30.3%) participants were illiterate. Almost six-tenth (61.9%) participants were involved in unskilled or semi-skilled work and two-fifth (38.1%) participants were homemakers. Majority of participants (96.7%) were registered in first trimester. Most known factor during pregnancy as danger sign was bleeding (81.9%). BPACR index was calculated as ∑Indicator/7 which was observed to be 62.3%. There was statistically significant association between awareness about health problems during pregnancy and type of family. Conclusion: Raising awareness regarding components of BPACR among antenatal women will help to reduce morbidity and mortality in antenatal women and achieve the sustainable development goal.