Mother-to-Child Transmission of HIV (MTCT) has infected a large numberrnof infants in Sub-Saharan Africa, including Ethiopia. However, the risk of MTCTrnhas dropped to as low as 2% in developed countries since the introduction of antiretroviralrndrugs. MTCT can occur during pregnancy, labor and delivery, and afterrnbirth through breast-feeding. The prevention of MTCT depends on the health carernsystem and community based organizations and structures. The purpose of thisrnqualitative and evaluative study was to find out the factors determining the seropositivernmothers’ PMTCT service utilization and know where the gap is. Findingsrnrevealed a number of factors for PMTCT service utilization. These center on lackrnof resource capacity at the health facilities to render necessary services, lack ofrncoordinated care and support, lack of male partners’ involvement, lack of homernbased care, safe-home birth practices, and lack of community involvement in thernprogram. On provision of a range of services, the MTCT should not only focus onrnsaving the child but also on the health and psychosocial well-being of the motherrnand the family