Background: According to the World Health Organization, roughly 16 million teen mothers aged 15 to 19 give birth annually resulting a 44,000 births per day worldwide. Moreover, the vicious cycle of poverty in sub-Saharan Africa is exacerbated by adolescent pregnancy, this also increases maternal, perinatal, and infant mortality hindering SDG goal 5 and target 3 of ending the child marriage of 2030 to be achieved. This study aimed to identify the prevalence, trends, and determinants of teenage pregnancies in Rwanda between 2010 and 2020.

Methods: This study used Rwanda's demographic and health survey data from 2010, 2015, and 2020, and a cross-sectional study design. All data were cleaned and appended to get the final data set for analysis, all analyses were performed using R software package 4.3.1. Moreover, statistical significance was determined at a 5% p-value and 95% Confidence Interval (CI) while not crossing one.

Results: The total number of teenagers between 2010 and 2020 was 9,050 and among them, the prevalence of teenage pregnancy was 6.11% (n = 553/9050). By trend, teenage pregnancy in 2010 was 6.22%, in 2015, 7.30%, and in 2015 5.41% in prevalence. After adjusting the variables in a multivariate logistic regression model, the following were found to be potential predictors of teenage pregnancy in Rwanda: Region by Eastern province (AOR: 1.55:95% CI: 1.078,2.24), lack of education and primary school teens (AOR: 2.9:95% CI: 1.22,6.89) and AOR: 1.67:95% CI: 1.25,2.24)respectively, Poorest households AOR: 2.02:95% CI: 1.27,3.12), those with knowledge of contraceptive methods (AOR: 8.70:95% CI: 3.34,23.01), sexually active unmarried women (AOR: 3.50:95% CI: 1.58,7.78), teens who did not access social media (AOR: 2.03:95% CI: 1.41,2.91), and it was protective against family size.

Conclusion: These results imply that a combination of social, sociodemographic, and knowledge-related factors, as well as awareness of contraceptive techniques, may impact teenage pregnancy in Rwanda. The provision of contraception education and awareness should be the primary goal of efforts to minimize adolescent pregnancies in Rwanda, particularly in areas where the prevalence is higher. In addition, encouraging family planning and tackling economic inequalities can be effective tactics to lower adolescent pregnancy rates.