Abstract:Background:Teenage pregnancies are associated with negative obstetric, foetal outcomes and social consequences. Aim: The present study aimed at identifying risk factors for teenage pregnancies. Methods and material:This was a community based comparative study conducted in three districts of Colombo, Anuradhapura and Batticaloa in Sri Lanka. For each of the 510 pregnant teenagers, 508 age matched non-pregnant females were identified from the neighbourhood. Information related to individual level, family level and societal level risk factors were collected by trained interviewers using a structured pre-tested. Risk factors were assessed in univariate and multivariate analyses. Results: Tamil (OR=3.31) and Muslim (OR=1.92) ethnicity were predictors of teenage pregnancy. Lower level of formal education (OR=1.95) and lack of knowledge on disadvantages of teenage pregnancies (OR=3.79), less support from the teachers (OR=3.47) and lack of strictness in family (OR=2.01) have also contributed to teenage pregnancy. Teenagers with a higher confidence in decision making (OR=2.11) were also at risk of becoming pregnant. Conclusions: Most of the risk factors identified were modifiable and preventive interventions are suggested.