According to National Basic Health Research (Riskesdas) 2013, the prevalence of anemia in pregnant women in urban area is 36.4%. The treatment of anemia in pregnant women is conducted by administering 90 iron tablets during pregnancy. The majority of anemia in pregnant women is mostly caused by lacking of iron (Fe) due to lack of adherence in taking iron tablets. The objective of this research was to assess the effectiveness of leaflet compared to counseling to improve adherence and increasing hemoglobin status of pregnant women with anemia in primary health care in Bogor District. The research design was quasi-experimental by giving counseling as an intervention conducted by pharmacists to 79 pregnant women with anemia in Cibungbulan primary health care and delivering leaflet to 79 pregnant women with anemia in Ciluengsi primary health care Bogor District in 2013. The evaluation was conducted by using MMAS-8 (Morisky Medication Adherence Scale) questionnaires and Hb rate with STAT-Site MHgb equipment a month after the intervention. Data analysis was carried out with Chi-Square test, Wilcoxon test, Mann-Whitney test and multivariate logistic regression analysis. This research suggests that either counseling by pharmacist or leaflet increases adherence to take iron tablets (P < 0.05). The effectiveness of leaflets and counseling to increase adherence to pregnant women with anemia were not statistically different. Pregnant women with anemia who adhere to take iron tablet have their Hb rate improved 3.24 times compared to those who do not adhere to take iron tablet. Pregnant women with anemia who eat food source of heme every day have their Hb rate improved 2.31 times compared to those who do not eat food source of heme every day.