Objective(s) The management of lower urinary tract symptoms (LUTS) is crucial for providing quality pregnancy care. This study aims to determine the prevalence and predictors of LUTS in pregnant women. Study design This cross-sectional study was conducted between November 2023 and February 2024 with a total of 1703 pregnant women who attended routine pregnancy care at four state hospital obstetrics outpatient clinics. Data were collected using a pregnant woman information form and the "Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF)". Descriptive statistics, the independent sample t-test, analysis of variance (ANOVA) test, Tukey or Tamhane's T2 post-hoc tests, and multiple linear regression (Stepwise) analysis were carried out. All analyses were conducted with a 95 % confidence interval and a significance level of p < 0.05. Results The prevalence of LUTS among pregnant women was found to be 99.2 %. High prevalence rates were obtained for storage symptoms, voiding symptoms, and urinary incontinence symptoms (respectively, 99.2 %, 48.8 %, and 61.2 %). Multiple linear regression analysis indicated that previous pregnancy stress urinary incontinence (SUI), history of curettage and urinary tract infection (UTI), absence of episiotomy, presence of SUI in the mother and/or sister, smoking, being employed, and being in the third trimester are significant predictors of LUTS during pregnancy (p < 0.05). Conclusion(s) The findings of this study indicate that LUTS is commonly in pregnant women. For quality pregnancy care, it is recommended to organize community-based, repeated educational programs and counseling services aimed at preventing and reducing LUTS in women.