Urogenital Ureaplasma is associated with urethritis, pelvic inflammatory disease, infertility and adverse pregnancy outcomes in sexually active reproductive aged women. However, it is also frequent in healthy women. The aim of this study was to determine the prevalence and species distribution of Ureaplasma in symptomatic and asymptomatic reproductive aged urban Gambian women (n =179, 20 – 49 years). A questionnaire was administered and endocervical and high vaginal swabs were collected from each participant for the detection of Ureaplasma, Mycoplasma genitalium, Chlamydial trachomatis by real-time PCR, and Trichomonas vaginalis and bacterial vaginosis by microbiological analysis. Ureaplasma was identified in 82 (45.8%) women, of which 45% were symptomatic and 48% asymptomatic. The incidence of Ureaplasma was higher in the 31 – 35 age groups 21 (58.3%). 10% of women who were positive for Ureaplasma were co-infected with T. vaginalis. Bacterial vaginosis was also found in 21% of women with Ureaplasma infection. The most common species in both study groups was Ureaplasma parvum (81.7%). Mycoplasma genitalium and Chlamydial trachomatis were not detected in any of the samples. Risk behaviour analysis shows that 88% of study participants’ partners do not use condom during sexual intercourse. The majority of the study participants reported having one life time sexual partner but are in a polygynous relationship. Bivariate analysis shows that infection with T. vaginalis and using hormone contraceptives for >10 years are risk factors but not significantly associated with Ureaplasma infection (p > 0.05). This is the first study carried out in urban Gambia and it shows that > 40% of sexually active reproductive aged women harbour Ureaplasma either in their cervix, vagina or both, which if left untreated can lead to ascending infection resulting in gynaecological complications.