Introduction: Assessing mothers’ satisfaction with maternal health service is very important. This is because it is critical and should be considered when making maternal health services more responsive to people’s needs. Objective: To assess and compare the maternal health service satisfaction of mothers in urban and rural areas of Enugu State, South East Nigeria. Methodology: This study was a community-based comparative, cross sectional study that assessed and compared the maternal health service satisfaction of mothers in urban and rural areas of Enugu State, South East Nigeria. The analysis was done according to the specific objectives using generated tables, ratios, frequency, percentage calculations and cross tabulations. Chi-square test of significance for test of comparison of qualitative categorical data, Student t-test for group comparison of means, Bi-variant, and Multivariate Analysis using logistic regression were used in the analysis of data at 95% confidence interval. P-value was set at 0.05. Results: 5.5% of mothers in the urban areas were satisfied with maternal health service they received when compared to mothers (79.2%) in the rural areas. Mothers in urban areas who had one pregnancy were 7.051 times less likely to be satisfied with the maternal health services when compared with other women. Mothers who obtained maternal health service from health post, Primary health care centres (PHC), district hospitals, tertiary facility, private hospital, and had less education were more satisfied with the services when compared with those who received care from Traditional Birth Attendants (TBAs) and spiritual homes. According to the mothers in both locations, the Factors that affect their utilization of maternal health include poor quality of maternal health service, high cost of obtaining the limited services, inadequate maternal information, in adequate staff, and bad attitude of health care workers attending to them. Conclusion/Recommendation: There is need to maintain this observed finding. However, there should be an improvement on health talk and health education given to mothers, to enable them have a better perception of their maternal expectations. This will enable the mothers to properly grade their satisfaction with maternal health services. Government should further train the health care workers including TBAs, and closely monitor the activities of spiritual homes.