OBJECTIVES: Mental health of pregnant women is essential for maternal and neonatal health. However, there is lack of statistics of antenatal depression in China. The study aimed to investigate the prevalence of antenatal depression and explore its risk factors among pregnant women in Chengdu of China. METHODS: Women at third trimester of pregnancy were screened for symptoms of depression at antenatal clinics of West China Second Hospital between 28 October 2013 to 28 February 2014 based on the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) and a psychosocial risk factors checklist.  RESULTS: A total of 2243 pregnant women aged 30.0±4.0 years participated in the survey. The mean EPDS score was 8.43 (standard deviation: 3.97). With a threshold score of 13, 14.2% were screened as having symptoms of depression. Age (P=0.007), education level (P＜0.001), occupation (P=0.001), number of children (including the fetus) (P=0.018), number of miscarriage/abortion (P=0.048), and age of first pregnancy (P=0.001) were associated with antenatal depression in univariable analysis but not multivariable analysis (P>0.05 for all). Women who were dissatisfied with living conditions (OR=1.81; 95% CI: 1.38-2.38), had a poor relationship with mother-in-law relationship (OR=2.20; 95% CI: 1.65-2.92), and had unplanned pregnancy (OR=1.34, 95% CI: 1.02-1.76) were more likely to show antenatal depression symptoms. CONCLUSIONS: Our study shows antenatal depression might be prevalent among Chinese women in Chengdu. Early detection and intervention for antenatal depression may be necessitated to improve maternal and neonatal health after more systematic studies and reliable data are available.