Antenatal care (ANC) may be broadly defined as encompassing pregnancy- related services provided between conception and the onset of labor with the aim of improving pregnancy outcome and/or the health of the mother and child. Family physicians with advanced fellowship training are capable of managing higher quality pregnancy care. Aim of the study: Assessment of the quality of antenatal care services introduced in four primary health care centers in El-Fayoum Governorate, also assessment of knowledge and practice of pregnant females to services they should receive during pregnancy. Methodology: A cross sectional descriptive study was done in which 204 pregnant females were interviewed by a questionnaire about the antenatal care services, with observation check list to the health care provider during providing ANC services. The results: Nearly all the pregnant females were not examined abdominally by health care provider, while all females are immunized by tetanus toxoid. About satisfaction of the participants about the services introduced to them most of the participants were not satisfied by waiting time, nutrition education, discussion of pregnancy problems, also the majority of the participants didn’t find the medications prescribed for them .About knowledge of the participants although 76% of the participants knew that 1st trimester is the suitable time for 1st ANC visit Only 50% of the participants started ANC in 1st trimester. Most of the participants knew that CBC, urine analysis from important investigation during pregnancy, while only35.8% said that the number of antenatal care visits is ≤4visits.The knowledge of them was high with blood pressure importance as routine examination ; on the other hand most of pregnant females didn’t know blood sugar test as part of routine antenatal care. Conclusions: Quality of antenatal care services as stated by the participants has weak points at health education, delay in the 1st ANC visit, also there is some difference between rural and urban centers in the quality of services introduced to pregnant females, as in health education, presence and cleaning of waiting area.