Background: The utilization of antenatal care from a trained provider is important to monitor the pregnancy and to reduce morbidity and mortality risks for the mother and child during pregnancy and delivery. Methods: A communitybased cross-sectional study was conducted in Menit-Shasha Woreda Bench Maji zone, southwest Ethiopia. Quantitative and qualitative methods were employed for data collection. Simple random sampling technique was used to select the study localities and subjects (mothers) those who gave birth in the last five years prior the survey period. Quantitative data was analyzed using SPSS for windows version 16 and qualitative data was narrated thematically and triangulated with quantitative findings. Results: A total of 639 women participated in the quantitative survey with respondent rate of 98.15%. The proportion of women who received antenatal care for their last pregnancy was only 15.5% (99). Out of this 10.3% received two to three visits. The main reasons mentioned for not attending antenatal care were lack of awareness, 490 (76.7%) and absence of health problems during last pregnancy, 469 (73.4%). Multivariate analysis showed that there was significant association between antenatal care service utilization and ANC visit by health extension workers (AOR=4.042, 95%CI: 1.982, 8.244,) and residential distance (AOR=4.214, 95% CI 1.025, 17.325), respectively (p<0.05). Conclusion: This study revealed low antenatal care service utilization. From those who had antenatal care service, the majority started it lately and received incomplete service. The utilization of antenatal care was influenced by home visit by health extension workers and by residential distance from health post. Thus it was recommended to strengthen home visit for improving community awareness on importance of ANC utilization.