BACKGROUND: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees' perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. MATERIALS AND METHODS: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. RESULTS: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4-98.4%) and natal services (92.7%; 95% CI 89.2-95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X (2) = 4.61, P = 0.032), married (X (2) = 9.70, P = 0.008) and multiparous (X (2) = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X (2) = 26.94, P = 0.000) and natal (X (2) = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. CONCLUSIONS: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services.