Background: Malaria remains a major cause of maternal morbidity and mortality in sub-Saharan Africa. In Bouaké, malaria prevention among pregnant women takes place in a context of high endemicity, characterised by the coexistence of biomedicine and traditional therapeutic practices. Objective: This study aims to analyse the social and cultural logics shaping malaria prevention behaviours during pregnancy, despite the implementation of national and international control policies. Matérials and Methods: A mixed-methods approach was adopted. Quantitative data were collected through a survey of 150 pregnant women attending three maternity wards in Bouaké (Ahougnanssou, Belleville, and Nimbo). Qualitative data were obtained from three focus group discussions involving 36 participants and three semi-structured interviews with midwives. Results: The findings indicate a high level of awareness regarding malaria transmission, predominantly attributed to mosquito bites. However, knowledge of severe pregnancy-related complications, such as prematurity, low birth weight, and maternal mortality, remains limited. Long-lasting insecticidal nets and intermittent preventive treatment with sulfadoxine-pyrimethamine are widely recognised, yet their effective use is inconsistent. In addition, 78% of respondents report resorting to traditional practices, particularly medicinal plants, regardless of educational level. These behaviours reflect a form of therapeutic syncretism, in which local remedies coexist with biomedical interventions perceived as effective but sometimes restrictive. Conclusion: Malaria prevention during pregnancy cannot be addressed solely through biomedical interventions. Context-sensitive strategies that incorporate sociocultural realities and strengthen community involvement are essential to bridge the gap between recommendations and actual practices.