The study aimed at examining the relationship between contraceptive use and fertility in Western region, Uganda, using a sample of 1993 women from the Uganda Demographic Health Survey of 2000-2001. Uganda Demographic Health Survey (UDHS) 2000-2001 is the third survey conducted by the Ugandan Ministry of Health. Chi-square, Logistic regression and multiple regression were used to test and determine factors contributing to the high fertility levels and low contraceptive usage in the region. Results show that the region has a total fertility rate of 6.4, and childbearing is not evenly distributed among age groups. Fertility peaks at ages 20-29, and reduces sharply with women in their late reproduction span. Contraception and fertility are inversely correlated. Though knowledge on contraception is universal, contraceptive prevalence remains low (95% and 16% respectively) among women of reproductive age. Family planning approval is inversely related with contraceptive use. Findings reveal that contraceptive prevalence plays minor role in explaining fertility levels as compared to some socioeconomic factors. Education is significantly and inversely related with fertility, but positively correlated with contraceptive use. The government should revisit the population policy to actively promote family planning activities by promoting and facilitating debates about family size, and the means to achieve. Women education needs to be emphasized in order to promote innovative reproductive behavior. More research to explore whether women are using contraception for spacing rather than limiting is required.