OBJECTIVE: The study was conducted to assess clients' satisfaction with PMTCT services on privacy, waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. METHODS: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services. Data collection method involved both client exit interviews and focus group discussions (FGD) with women attending RCH services. Systematic random sampling technique was used to obtain the required sample of 208 clients for the exit interviews. A total of five FGDs were conducted each with eight to ten people. The data obtained were analysed using Epi Info. SETTINGS: Dodoma Rural district, central Tanzania RESULTS: Of 113 clients' who accessed PMTCT services, 75.2% were satisfied with the counselling provided. A significant difference (P = 0.02) was observed between clients with no formal education as compared to those with primary level of education and above. Nearly a quarter of the clients who accessed PMTCT of HIV services were not satisfied with the privacy in the settings providing the service. It was also found that 71.7% of clients accessing PMTCT of HIV service was satisfied with the waiting time spent for the service; however a difference was observed (P = 0.001) between clients who accessed services at health centre (77.6%) and hospital (33.3%). CONCLUSION: A quarter of the clients were not satisfied either with the counselling they received on PMTCT of HIV, privacy or waiting time they spent while accessing services. Some of the reasons contributing to dissatisfaction included inadequacy in individual counselling, inadequate on site test supplies and equipment and cost incurred when travelling to seek for PMTCT service from a referral or satellite health facility.