PURPOSE: The main aim of this study was to systematically assess the factors that influence maternal health care services utilization by women in Awash Fentale woreda (district), Ethiopia. DESIGN: A quantitative, descriptive, and cross-sectional design was selected as the methodology for this study. METHOD: Data were collected using a structured questionnaire administered to 422 women aged 15 to 49 years through a stratified sampling technique. Data was entered, analyzed and interpreted using SPSS computer program. Binary logistic regression model was used to identify the factors that influence maternal health care services utilization. RESULTS: The findings of this research indicated that not attending school, not watching television, and not owning a Bajaj (three-tire motorbike) significantly influenced low utilization of antenatal care (ANC) visits, while exposure to media, including reading newspapers, was positively associated with the adequacy of ANC visits. Similarly, factors such as not attending school and not watching television at all influenced delivery care (DC) services utilization negatively, while husbands’ low income and not watching television at all were negatively associated with postnatal care (PNC) service utilization. This research study found that 80 (19%) of the respondents preferred to give birth at home and the remaining 342 (81%) preferred a health facility for their delivery services. In addition, 43% of the respondents were not satisfied with the care and attention given by the health care provider and approximately 52% of the respondents were not satisfied with the cleanliness of the health facilities. It was also illustrated in this study that family members’ influence was one of the major barriers identified for DC services utilization. Conclusion: Policy making, planning, and implementation should focus on factors that influence maternal health care services utilization and barriers to DC services. In order to increase the utilization of maternal health care services by women with low levels of educational status, husbands ’low income or wealth quintile, and low media exposure, strategies were developed by the researcher. / Health Studies / D. Litt. et Phil. (Health Studies)