The study was conducted to investigate determinants (clinical, nutritional, and nonnutritional factors) of anemia among pregnant women in Kassala, eastern Sudan. Sociodemographic characteristics were gathered; serum ferritin, zinc, albumin, and C-reactive protein were measured using different laboratory methods in a cross-sectional study of 250 pregnant women. Of the 250 women, 58.4% had anemia (hemoglobin (HB) <11 g/dl), 6.8% had severe anemia (HB < 7 g/dl), 19.6% had iron deficiency (S-ferritin <15 µg/l), 14.8% had iron deficiency anemia (<11 g/dl and S-ferritin <15 µg/l), and 38% had zinc deficiency (<80 µg/ml). S-albumin, zinc, and ferritin were significantly lower in patients with severe anemia. While age, gestational age, ferritin, and C-reactive protein were not predictors for anemia, primigravidae (OR = 2.7, 95% CI = 1.1-6.7, P = 0.02), low S-albumin (OR = 5.9, 95% CI = 1.4-25.2, P = 0.01), and low S-zinc (OR = 2.6, 95% CI = 1.0-6.6, P = 0.03) were the predictors for anemia. While there was no significant correlation between hemoglobin, S-zinc, and S-ferritin, there was a significant positive correlation between hemoglobin and S-albumin (r = 0.308, P = 0.001) and significant inverse correlation between hemoglobin and C-reactive protein (r = 0.169, P = 0.007). Thus, the role of chronic inflammation and zinc as possible contributing factors to anemia in pregnancy has important implications for the clinical evaluation and treatment of these women.