Purpose: The aim was to assess the awareness, attitude, knowledge level and practice of pregnant women on preconception care at the Tamale West Hospital Antenatal clinic in the Northern region of Ghana.Methodology:  This study used a descriptive cross-sectional design with a quantitative approach. A quota sampling procedure was used to arrive at 200 participants. The starting point was randomly selected and a systematic random sampling method was used to select the study participants. Simple random sampling using the lottery approach was used to select the participants for the study. The target population was women (literate and illiterate) within the age range of 16 and 40 years attending the Tamale West Hospital for antenatal care. The list of all the women who fell within the target population was obtained from the register of the unit. The inclusion criteria were pregnant women who visited the Tamale West Hospital within a month’s duration for antenatal care services. A semi-structured questionnaire which had both open-ended and close-ended questions was used to generate the data. Descriptive statistics which involves frequencies and percentages was used to represent both independent and dependent variables of the study. Close-ended responses were inputted using the Microsoft Office Excel 2016. Open-ended responses were compiled in relation to the objectives of the study. Other relevant outcomes were cross-tabulated using SPSS version 21.Results: Though 20.0% of the pregnant women had positive attitude towards preconception care, only 34.5% were aware of preconception care and 42.5% and 23.5% had poor and high knowledge levels on preconception care respectively. When the age group was cross-tabulated with awareness, the results showed no statistical significance between the two variables (χ2=9.1; p=0.58). However, there was an association between the educational status (Tertiary level) (χ2=49.6; p=0.01) and religious affiliation (Muslim) (χ2=43.3; p=0.01) of the respondents on awareness. Educational status (Tertiary level) (χ2=45.4; p=0.01) and religion (χ2=21.3; p=0.01) were found to influence knowledge statistically. In terms of overall attitude, only Muslim (χ2=4.12; p=0.04) statistically impacted on the study.Conclusion: Pregnant women who attend Antenatal clinic at Tamale West Hospital tended to have low level of awareness and poor knowledge, they have negative attitude towards preconception care services and seldom practice preconception care. There is the need for health care authorities to intensify awareness and implement preconception care policies.Recommendation: The present study demonstrated that there was a need to create awareness which can also increase the knowledge and practices of reproductive age women or couples. Hence, there is the need for health authorities to put together comprehensive preconception care policies for health institutions to abide by.