Each year a large number of women are dying due to factors associated with pregnancy and childbirthrnin developing countries. Antenatal and delivelY care are the most important interventions for reducingrnmaternal and child mortality.rnA community based cross-sectional survey was conducted in Februwy 2009 with the main objective ofrnassessing socio-economic alld demographic factors that determine antenatal and delivelY carernutilization in rural kebeles of Kalu wereda, Debub Wollo Zone, Amhara Region. Simple randomrnsampling technique was used to select representative kebeles and enumeration areas. A total of 312rnwomen who were pregnant at the time of the surveyor had live births within the 3 years preceding thernsurvey date were the respondents for the survey. Quantitative and qualitative methods of datarncollection were employed to gather the required infonnation ji-om the respondents.rnThe result of the study revealed that 37.2% of the women received ANC either during the currentrnpregnancy or at the time of their previous pregnancies and the majority of them (65.5%) made 2-3rnANC visits. About 40% of 1V0men visited health facilities for ANC check up ill the third trimester ofrntheir pregnancy. Concerning the latest births, (85.2%) of the babies were delivered at hOllle and aboutrn37% and 25% of the deliveries were attended by untrained traditional birth attendants and relatives,rnrespectively.rnThe bivariate test shows that age, average monthly income, total children ever born, average timerntaken to reach the nearest health facility and education have statistically significant association withrnutilization of ANC with (X1=1 01 .7, P=O.OOO), (X2=23.7, P=O.OOO),( x'=53.4, P=O.OOO), (X2=21.1,rnP=O.OOO).( X'=50.9, P=O.OOO)). In addition, age, average monthly income, total number of childrenrnever born, average time taken to reach the nearest health facility and education also showsrnstatistically significant association with utilization of health facility delivelY with (x'=8.1, P=0.017),rn(x'=9.9, P=0.007), (x'=12.5, P=0.002), (x'=l/, P=O.OOI) and (X2=12.2, P=O.OOO), respectively.rnMoreover, the multivariate analysis revealed that age, average monthly income, awareness aboutrnbenefit of ANC have significant relationship with utilization of ANC. Likewise, total number ofrnchildren ever born, marital status and access to radio are found to have significant effect on utilizationrnof health facility delivelY. Being in a state of good health was the main reason for not using ANC,rnwhile, it is usual practice is reported as the main reason for home delivelY.rnPromoting the use of ANC, postnatal care and facility-based and safe home based deliveries byrnproviding information and education on maternal service utilization, encouraging women educationrnand improving the status of women in the community are recolllmended.