Introduction: The aim of this study was to identify the prevalence and factors associated with regular use of ANC services among mothers of children under one year of age in rural communities in Nepal. WHO has estimated that developing-region maternal mortality still remains as the leading cause of death among reproductive-age women, accounting for approximately 99% of global maternal deaths in 2015. Method: A community-based crosssectional study was conducted in Banke District, Nepal among a sample of 364 pregnant women who delivered within last 12 months using face-to-face interviews with a semi-structured questionnaire. Results: Nearly 56% of women used standard ANC services in the last pregnancy (i.e., four or more check-ups). Around 30% of mothers had at least one complication during the pregnancy. ANC visits increase with decreased distance from a health center (AOR=2.197, 95% CI=1.165-4.144), decreased travelling cost (AOR=2.573, 95% CI=1.062 –4.484), decreased waiting time for service (AOR=2.940, 95% CI =1.445-5.981), increased quality of ANC services (AOR =2.099, 95% CI=1.247-3.536) and increased satisfaction of service (AOR =1.942 , 95% CI =1.212-3.110). Increased positive perception about ANC also increased the number of ANC visits. Further information from TV programs also helped to increase ANC visitation. Conclusion: Factors affecting regular utilization of ANC services were affordability and accessibility, such as distance to the health center, travel cost, waiting time, quality of ANC services and service satisfaction among lower-income, rural Nepalese women.