Little is known about intimate partner abuse (IPA) among couples during pregnancy in Iran. This study aimed to compare the rates of IPA by pregnant women towards their husbands (perpetration), and women’s experience of IPA from their husbands (victimization) and determine the predictors of the two behaviours. The cross-sectional study was conducted on 525 pregnant women at 24–30 weeks of gestation visiting governmental health care centres/posts in Tabriz, Iran, in 2014. The study sample was selected using random cluster sampling. The Revised Conflict Tactics Scale (CTS2) was used to assess IPA perpetration and victimization. The McNemar test was employed to compare the prevalences of IPA perpetration and victimization, and adjusted logistic regression was utilized to determine the socio-demographic predictors of overall IPA perpetration and victimization. The overall rates of women’s reported abuse of their husbands (perpetration) and women’s experience of abuse from their husbands (victimization) were 70% and 67%, respectively, but the difference was not statistically significant (p=0.086). The prevalence of psychological aggression perpetrated by women towards their husbands was significantly higher than that experienced by the women from their husbands (65% vs 58%, p<0.001). The prevalences of sexual coercion (15% vs 30%) and injury (8% vs 16%) perpetrated by women on their husbands were significantly lower those they experienced by the women from their husbands (p<0.001). There was no statistically significant difference between the prevalence of perpetration of physical violence towards husbands by women (19%) and that experienced by women from their husbands (22%) (p=0.072). Women’s and husbands’ satisfaction with their own occupations were predictors of both perpetration and victimization of IPA. The observed high rates of IPA perpetration by, women and victimization of, women during pregnancy, and the significantly higher rate of violence towards women compared with that perpetrated by women, especially for sexual coercion and injury, require health policymakers and care providers to make serious efforts to identify such violence, and take appropriate measures to reduce it, during pregnancy in women in Iran.