Objective: To compare prenatal care coverage between adolescent (early and late) and adult pregnant women in Iquitos, Peru. Methods: A random sample of 4467 birth records was collected. Multivariate analyses were performed to compare prenatal care coverage in all adolescent (10-14 years, 15-19 years) and adult (≥ 20 years) age groups and then for primiparous women only. Results: The mean number of visits was 5.0 for adolescents aged 10-14 years, 6.1 for adolescents aged 15-19 years, and 6.2 for women aged 20 years or older. For primiparous women, the means were 5.1, 6.2, and 6.8, for the respective age groups. Both the proportion attending and the number of prenatal visits were significantly lower in primiparous adolescents aged 10-14 years than in primiparous women aged 20 years or older (aOR 0.25; 95% CI, 0.10-0.62 and aRR 0.83; 95% CI, 0.74-0.94, respectively). Conclusion: All women attended prenatal care more frequently than the WHO's recommended 4 visits; however, early adolescents attended significantly less often than late adolescents or adult women. Further study of this inequality is warranted to adequately inform local health services. © 2009 International Federation of Gynecology and Obstetrics.