Abstract Background Women living in Roma settlements in Slovenia had worse perinatal health indicators comparing with women from the rest of population. They gave more births in younger age and used fewer preventive services and later in pregnancy. Roma children had higher chances to be born earlier and with lower birth weight. We explored the differences in provided hospital services between pregnant Roma and the rest of female population in Slovenia. Methods We identified the female inhabitants of Roma settlements from the national registry of population and separated from the rest of the population data. Health indicators were provided from the national health register - Perinatal Information System for the years from 2018 to 2022. The frequency statistics, ANOVA and comparison of column proportion tests were used (p-value<0.005, 95% CI) to compare the differences in categories of services in those two groups. Results Statistically significant differences were found in several hospital services comparing treatments of pregnant females from Roma settlements comparing to the rest of female population. Women from Roma settlements had higher ratio of gynecologic history without remarks, fewer treatments and less prevention investigations in prenatal period and higher ratio of natural start of delivery. In addition, by Roma females was used less medication during delivery, less episiotomies and fewer caesarean section were performed. Conclusions There are significant differences in provision of hospital services between female inhabitants of Roma settlements and the rest of population. Some of them could be explained by younger average age of delivery in Roma, but additional research would bring more light in possible impact of socio-economic and cultural determinants on both the use and provision of health services. Key messages • There are differences in provided health services between Roma women and the rest of female population. In depth research of prenatal and hospital services would bring additional explanations. • Considering the health inequalities which start by birth, targeted and tailored actions to improve health of Roma women and their new-borns are appropriate and necessary.