Background: Emergency contraception ( EC) is widely accepted as a safe method of preventing conception following unprotected coitus. Use of EC has been promoted in South Africa, yet uptake among women appears to remain low. Aim: The aim of this study was to access knowledge and use of EC among women presenting for termination of pregnancy at a district hospital in KwaZulu-Natal. Methods: This was a hospital-based cross-sectional study. Data were collected from women attending a termination of pregnancy ( ToP) service at a district hospital using a questionnaire and analysed descriptively. Results: A total of 218 women participated, of whom 25% were under 20 years of age and 87% were single. Reported knowledge of EC was good with 70% of participants indicating that they knew about EC. However, knowledge around EC was not complete, with less than 50% knowing the time interval between intercourse and EC action and some believing that EC acted by inducing an abortion. Reported usage of EC was only 40%. Conclusion: This study revealed that there is much more to be done to enhance knowledge and use of EC in this context. Reasons for the discrepancy between knowledge and usage need further exploration.