All pregnant women are at risk for becoming anemic, that is because iron need for mother and fetus gradually increases during pregnancy and reaches its highest level at the end of the pregnancy. The aim of this study was to evaluate the effect of a nutritional educational guidline (NEG) on knowledge and knowledge related practice of pregnant women with iron deficiency anemia ( IDA) at rural areas. The intervention design was conducted at three maternal and child health care centers in Kalyobia Governorate (Moshtoher, Kafr Shoukr, and Kaha). A total 200 rural anemic pregnant women were selected from these maternal and child health centers. One tool was utilized in this study, a structured interviewing questionnaire for assessment of the studied sample characteristics and their knowledge regarding iron deficiency anemia as well as their knowledge related practice. A significant increase in overall knowledge and knowledge related practice toward healthy nutritional habits after intervention was detected and subsequently the prevalence of anemia slightly decreased after intervention of the NEG (24%), than before. This study clearly showed that NEG can bring about an improvement in knowledge and knowledge related- practice of pregnant women toward IDA. The study recommended that nutrition should be mandated as a required component of comprehensive health care putting clear guidelines of the nutrition services, that nurse should provide to the pregnant women in primary health care facilitation in order to maintain proper health among pregnant women. Follow up HB level though pregnant women in rural area should be taken for early detection of anemia.