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Background. Depression is a common global mental health tragedy which affects more than 30 million people of all ages. Antenatal depression is higher among low-income countries where maternal and psychosocial factors act as determinant factors for its occurrence. Aim. This study is aimed at assessing the prevalence of antenatal depression and its associated factors among pregnant women attending health institutions of Faafan zone of Somali regional state, Eastern Ethiopia. Method. An institutional-based cross-sectional study design was conducted among randomly selected 403 pregnant women from January to September 2015. EPDS with 13 cutoff points was used to screen antenatal depression. Bivariate and multivariate logistic regressions were used to identify associated factors. Result. The study showed that 24.3% of women had antenatal depression. Marital status, educational status, chronic medical illness, previous depression history, and social support were factors associated with antenatal depression. Conclusion. The study revealed that the prevalence of antenatal depression was 24.3%. Ethiopia Federal Ministry of Health and Somali Regional Health Bureau should work very hard to create awareness on the importance of pregnancy planning and social support during pregnancy. [ABSTRACT FROM AUTHOR]