Background: Despite the implementation of various maternal health programs and schemes at both regional and national levels in Pakistan, maternal mortalities and morbidity remain significantly high. This suggests that maternal health services are being underutilized. Aim: This current study focuses on assessing the utilization patterns of maternal health services and the factors associated with their utilization in Rawalpindi, Pakistan. Methods: The cross-sectional study was conducted over one year (2021-2022) among mothers aged 15 to 49 years in the field practice area of DHQ Rawalpindi. The minimum required sample size was determined as 645. Participants were selected using a simple random sampling technique from a randomized list of villages. Data was collected through home visits, utilizing a pretested, standardized questionnaire. In the analysis, the significance of associations between variables was established at P<0.05. Results: Among the 645 potential participants, 632 provided consent for inclusion in the study. Only 58.3% of participants received any Antenatal Care (ANC), and a mere 11.7% received full ANC services. More than half of the participants (52.7%) had experienced pregnancy-related complications. Variables such as younger age and limited decision-making capacity were significantly associated with the lack of full ANC services (P<0.05). Conclusion: This study highlights that a woman’s age, literacy status, parity, socioeconomic status, and occupation are major determinants influencing the utilization of maternal health care services. These determinants should be taken into account when planning future interventions aimed at promoting attitudinal changes and, consequently, enhancing the utilization of maternal health care services.