Background: Quality care encourages health seeking behaviors of clients, motivates health providers, safe guard's client's health and ensures sustainability of the programs, however no adequate data is available on quality of antenatal care in Alexandria. Objective: To assess quality of antenatal care through client satisfaction, provider's performance and availability of basic and necessary equipment in seven selected family health units in Alexandria. Methods: A cross sectional study was carried out in seven family health units. One health unit was selected randomly from each of the seven administrative zones in Alexandria. Data were collected from clients of the antenatal care service, health providers and the seven health units. For the exit interview, a total of 427 women were selected by proportion to size of clients in each health unit and a structured pre-tested questionnaire was used. All the seven physicians working in the antenatal clinics were observed using observation check list while examining sampled pregnant women . An Observational checklist was used to assess the availability of instruments and medical equipments necessary for antenatal care. Results: Findings indicated poor structure in all the family health units. By observation, 91.3% of pregnant women received poor care while 8.7% received fair care. With concern to interpersonal and technical aspects of antenatal care received, 93.9% and 59.7% respectively had good level of satisfaction. Regarding constellation of services and continuity of care mechanisms, 90.4% and 50.1% of women respectively had fair level of satisfaction, while 54.8% had poor level of satisfaction with information and counseling. Conclusion: Overall satisfaction of antenatal care is high, although health providers did not follow proper management of the antenatal care service. Conclusion & Recommendations: Family health units should be equipped with essential medical equipments. Regular in-service training of health professionals on use of guidelines for examination and management of women attending antenatal care services is essential.