Background Unwanted pregnancies are still common in Central and Eastern European countries, including Serbia. Little is known about the use of contraception in different ethnic groups. This research was undertaken to investigate the use of contraception between Roma and non-Roma women in Serbia and factors associated with it.

Methods Data from the 2010 Multiple Indicator Cluster Survey (MICS4) conducted in Serbia were used. This research included 1082 Roma and 2145 non-Roma women aged 15–49. Univariate and multivariate logistic regression analyses were used to analyze socio-demographic factors associated with the use of contraception in both population groups.

Results Roma women use any type of contraception more often than non-Roma women. However, Roma women rely more on traditional and unsafe methods such as withdrawal and lactational amenorrhea method, but significantly less on modern methods such as pill, condom and intrauterine device. Place of living (region) is also associated with contraceptive usage.

Conclusions Inequalities in the use of contraception between Roma and non-Roma women exist. Promoting modern methods of contraception and education about the importance of the use of contraception should be in the focus of national health policies and strategies related to reproductive health to reduce these inequalities.