A community based cross sectional study was conducted from October to December 2004 in in Afar Regional state, Ethiopia to assess factors influencing utilization of maternal health care services. Analysis revealed that 79.6% of the women had at least one prenatal visit during their recent pregnancy. Most of the antenatal care (ANC) attendants made their first visit during their second trimester of pregnancy. Among ANC users 53% of had less than four antenatal care contacts. Majority of deliveries took place at home, of which 93.7% were attended by TBAs. Absences of a health problem, lack of awareness, work overload, and distant health service were the main reasons for no ANC attendance. . In conclusion, the study revealed low maternal health care utilization in the area. Demographic and socio cultural factors were found to be barriers to utilization of maternal healthcare services. Increasing maternal health service coverage and promotion of IEC in the community are recommended.