Background: Pakistan is the 6th most populous country of the world while contraceptive prevalence rate is only 30%. This study was conducted to investigate the knowledge, attitude and practices of contraception in women of reproductive age. Material & Methods: This descriptive cross-sectional survey was carried out from January to June 2011, at Gynae/Obs Unit, Women & Children Hospital, Kohat. A convenient sample of 900 was selected from reproductive age group (15-49 years), attending the outdoor. Data was collected on a questionnaire. Likert 3 point and 5 point scale was used about the knowledge and attitude of contraceptive respectively. SPSS version 16 and Statistic 9 were used to analyze the data. Results: The mean age of respondents was 30.76 +/- 7.641 years. The mean age at marriage was 18.19 +/- 2.982 years, literacy rate 37.8%, 95.2% women were house wives and 56.2% respondents had heard of some method. While enquiring their own attitude, 589(65.4%) gave positive response regarding the use of contraceptives and 734(81.6%) declared family planning as prohibited in the religion. Use of contraceptive was (30.8%). However, it was more common in grand multipara p<0.0001, >35 years old ladies p<0.0001, working women p<0.01 and those with education up to matric and above p<0.001. Husband education did not show significant difference on contraceptive use p=0.162. Conclusion: Frequency of contraceptive use is comparatively low in our set-up despite high level of awareness. Desire for larger family, pressure from husband, religious concerns and fear of side effects are the main factors responsible.