Teenage pregnancy is a serious public health and social problem with 95% occurring in developing countries. The aim of this study was to investigate the behavioral, familial and social factors associated with teenage pregnancy among teenage girls in itara parish, Rubaya subcounty-Mbarara district, Uganda. Primary data from a case-control study of teenage girls in itara parish, Rubaya subcounty- Mbarara district was analyzed. A structured questionnaire was administered to collect data on 67 participants, identified through simple random sampling from one village of itara parish, Rubaya subcounty-Mbarara district. Data analyses were done using statistics for descriptive. A total of 67 both males and females participated in the study. At bivariable analysis, all variables were significantly associated with teenage pregnancy. Among the behavioral factors assessed, multivariable analyses showed that having frequent sex and irregular contraceptive use increased the likelihood of teenage pregnancy. Among familial factors, being married was found to increase the likelihood of teenage pregnancy. Poverty, peer pressure and lack of control over sex was observed to increase the likelihood of teenage pregnancy. Demographic, behavioral, familial and social factors are important predictors of teenage pregnancy in itara parish, Rubaya subcounty-Mbarara. Interventions focusing on: accepting the victims (retaining pregnant girls at school), creating awareness and sensitization of information on sexual and reproductive health of teenage girls, providing guidance and counselling, provision and proper implementation of policies concerning against teenage pregnancy may come a long way to improving adolescent sexual and health services in the low-income settings. Keywords: Teenage pregnancy, Adolescent, Behavioral factors, Familial factors, social factors and Itara parish community.