Background: client's satisfaction is a measure of the extent to which clients are trustworthy with the health care which they received. Pregnant women's satisfaction is considered a performance indicator in antenatal care (ANC) quality evaluation. Objectives: To assess clients' satisfaction regarding antenatal health care services provided at the primary health care level in Sharkia governorates, Egypt. Methods: a cross-sectional study was conducted on 765 pregnant women. Through a multistage cluster sampling technique, four health facilities were selected to represent Sharkia governorate. Participants' data regarding socio-demographic characteristics, numbers of their antenatal visits and questions to assess the satisfaction about the quality of antenatal care were collected via semi-structured questionnaire. Results: The study revealed that out of the total participants, overall satisfied with ANC services were 288 (37.6%). The most common specific component of ANC that had good-satisfaction by the respondents was tetanus vaccine availability (100%). Shortage of referral requirements were the commonest causes of dissatisfaction. Clients who were urban residents, who had middle & high social class and who have ≥2 previous antenatal care visits were more likely to have the satisfaction in ANC services. Conclusion:  The results of the study reflect multiple pitfalls in the different components of the ANC services, so special attention must be given for increasing resources to improve the quality of ANC services in the governorate.