Aim: To enhance the proper utilization of ANC in Fayoum governorate. This is through providing the relevant stakeholders with the necessary information that would help formulation of fitting strategies. Study design and Methods: Descriptive cross sectional comparative study. An interview questionnaire was used. A convenient sample of women who had a live birth within four months and were attending an UHC; 100, and a RHU; 108. Results: The study women utilization pattern of ANC was generally satisfactory. Most of them had regular ANC and about two thirds started ANC visits early in the first trimester. Nonetheless, the role of PHC in providing ANC was very low if compared to private clinics. Study women perception regarding ANC was generally good. Most of them were satisfied from ANC they received in their latest completed pregnancy. On the other hand women knowledge about contents of ANC visits was poor. Results also highlighted the mismatch statistically significant factors that affect the pattern of ANC utilization among women in the UHC compared with those in RHU. While the age of the women, employment, the number of live birth deliveries and existence of obstetric/ medical problems in the latest completed pregnancy had their statistical significant association on the pattern among the study women attending the UHC, it was the age of the women and the number of live birth deliveries and community support among the study women attending the RHU. Conclusions: The ANC utilization pattern was generally satisfactory. The utilization of PHC for ANC was limited. Study women knowledge about the contents of ANC service was poor. Matchless factors could affect ANC utilization pattern among different women. Recommendations: Further research is needed to develop tailored strategies to enhance ANC utilization in individual communities. Until that happens, more efforts are needed to promote the role of PHC in ANC provision through addressing the quality features wanted by the served women. Target women need to be aware of the contents as well as the quality by which the ANC should be provided for them.