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In Uganda, only 25% of pregnant women-initiated ANC before 20 weeks gestation, and 48% of pregnant women didnot complete 4 ANC visits. Therefore, the purpose of this study was to determine the prevalence of late initiation ofANC and associated factors among pregnant women attending Fort Portal Regional Referral Hospital (FPRRH). Across-sectional study design using a quantitative research approach was employed for this study. A total of 200participants were recruited for the study for the period of one month and were selected using a simple randomsampling technique. Data were collected using interviewer-structured questionnaires which were filled by theresearcher with the help of research assistants. Data were entered into the SPSS software application and descriptiveanalysis was done using SPSS version 22.0. Results of the study revealed that the socio-demographic factorsassociated with delayed initiation of the first ANC visit were the age of 20-30 years; p=0.002 (OR=0.27) urbanresidence; p=0.016 (OR=2.32) and monthly income level <0.5M UGX p=0.004 (OR=2.70, 95). The currentpregnancy-related factors included short distance from the health unit p<0.001; (OR=0.13, cheap transport costp=0.002; (OR=0.25), planned pregnancy reduced p<0.001; (OR=0.16) and violation by the husband p=0.026;(OR=3.45). Previous pregnancy-related factors associated included recent caesarian section mode of delivery pvalue<0.001 (OR=0.14), use other contraceptive methods other than pills, injectables, and implants p-value=0.030(OR=2.82), and history of any gynecological surgery had a p value=0.001 (OR=0.12). According to the studyfindings, factors associated with delayed initiation of the first antenatal care visit included age, residence, distancefrom the nearest health unit, cost of transport, planned pregnancy, violation by the husband, recent mode of delivery,difficulty in vaginal delivery, contraceptive method ever used, injectables and implants and history of anygynecological surgery. We recommend that the government through the Ministry of Health construct healthcenters that provide ANC within easily accessible distance by pregnant mothers