Teenage pregnancies are becoming a major concern in Sri Lanka, with 6.5 percent of the total pregnancies registered during 2009 being in this age group. In view of the negative foetal, obstetric and social consequences associated with teenage pregnancies, it is necessary to develop effective interventions. In order to design interventions identification of factors contributing to teenage pregnancies is mandatory. This study was carried out, to describe the prevalence, trends and district differentials in teenage pregnancies using available data and to describe the underlying social, behavioral and other factors that influence/lead to teenage marriage and pregnancy. A cross sectional comparative study design was used.