Many of women in developing countries are at a great risk in terms of high maternal morbidityrnand mortality due to factors related to pregnancy and childbirth in these countries. A crossrnsectional study was conducted from February 15 to March 15, 2010 in Gozamin Woreda inrnAmhara Regional State to assess factors affecting utilization of maternal health care services. Arntotal of 587 women who had at list one live births in the five years preceding the survey werernselected systematically. Data were collected using a pre-tested and structured questionnaires andrnFGD were used to collect quantitative and qualitative data, respectively. The analysis revealedrnthat about 59.3% of the women had at least one prenatal visit during their recent pregnancy.rnAbout forty five percent of those women attending antenatal care had their first visit during theirrnfirst trimester of pregnancy. Among ANC users 64% of had less than four antenatal care contactsrnin the recent pregnancy. The most important reasons for not attending ANC care were beingrnhealthy and being too busy. Majority of deliveries took place at home; about 71% of deliveriesrntook place at home. Presence of relatives nearby, Transportation problem, and lack of privacyrnwere the main reasons cited for resorting to home delivery. The majority of the respondents werernable to name the danger sign of pregnancy related problems. In multivariate analysis the risk ofrnnon-attendance of ANC and home delivery was higher for those women whose residence wasrnrural, low educational status, higher parity and being housewife at old age. In addition ANCrnservice utilization significantly affect utilization of delivery care provided in health institutionsrn(P-value less than 0.05). In conclusion, the study revealed that more women attend ANC duringrnpregnancy than those derived at health institutions. Demographic and socio-cultural factors werernfound to be barriers to utilization of maternal health care services. Educating girls, providingrnhealth education on maternal health care services, and improving the services of health extensionrnworkers in rural areas were recommended to improve utilization of both services.