Introduction: Magnesium Sulphate (MgSO4) is the first-line treatment for severe pre-eclampsia and eclampsia, conditions that contribute significantly to maternal and fetal mortality worldwide. Despite its availability in Zambia, gaps in knowledge and competency among healthcare providers may hinder its effective use. This study aimed to assess the competence of nurses and midwives at Kapiri Mposhi District Hospital in the administration of MgSO4. Methods: This was a cross-sectional study where 100 respondents participated in the study. Participants were randomly selected. A structured questionnaires and checklists were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square tests was used to test the significance of the association between Knowledge on administration of MgSo4, Competence in MgSo4 administration, among nurses and midwives at Kapiri Mposhi District Hospital. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multivariate binary logistic regression model to determine predictors of practices and need for information was also used. Result: On analyzing the dependent variables, majority, 71% demonstrated competence in MgSo4 administration. More than half 69% of respondents had knowledge on MgSO4 administration and 58% were trained. However, 31% lacked knowledge, and 29% were either unskilled or had limited skills. Almost all (92%) of the respondents confirmed MgSO4 being readily available in the department while 73.9% of respondents actively used it. Associated barriers to utilization included fear of side effects and lack of mentorship. Conclusion: Lack of knowledge was the main reason associated with lack of competence in MgSo4 administration among 29% of nurses and midwives regardless of the period of being in service. Particular attention should therefore be given to ensuring that nurses and midwives undergo train