Background: Antenatal care is one of the most effective maternal health interventions for preventing maternal morbidity and mortality particularly in places where the general health status of the women is poor. In Egypt, there is overall increase in utilization of Maternal Health Services (MHS) but there is considerable variation between governorates. Objective: To determine utilization pattern of the antenatal care service (ANC) services in Qalyubia Governorate and factors that shaped it. Method: Comparative cross sectional study, conducted on 400 females attending two PHC facilities in Qalyubia Governorate from 1st January to 31thAugust 2017. Results: Females' perception of the importance of ANC was very high either urban or rural (99.5%). Urban females attending ANC health units were younger, more educated, of higher social class than the rural females. Urban females depend on printed methods as a source of health information more than the rural ones. No significant difference between urban and rural women considering the number of live children but the rural females experienced more number of pregnancies. All urban (100%) women started ANC visits as early as the 1st trimester with more frequent visits than the rural females and the majority of them (89.9%) obtain the services from private clinics. Considering barriers of utilization of ANC from the point of view of rural versus urban females, rural females considered unavailability of physician (70.8 vs. 25.3%) or presence of male physician (5.1% vs. 0.7%), lack of drugs (19.1% vs. 0.7%) or expensive treatment (6.7% vs. 0%), long waiting time (19.6% vs. 2.7%) and difficult transportation (4.5% vs. 0.7%) are the main barriers. Conclusion: The ANC utilization pattern was generally satisfactory. The utilization of PHC for ANC was limited. Much less factors could affect ANC utilization pattern among different women.