ABSTRACT: Maternal health services play a vital role in achieving improved reproductive health outcomes. However, levels of uptake and utilisation of available services in most developing countries, including Tanzania remain substantially low. This study assessed coverage and factors influencing uptake of maternal health services in Kondoa District in central Tanzania. Data were collected from a cross-sectional survey of 434 women of reproductive age who had given birth three years prior to the survey in ten selected villages, and analysed for descriptive statistics, chi-square tests and binary logistic regression. The study found that most of the respondents (84%) lived within five kilometers from a health facility where basic maternal health care services were provided, although health facilities were not sufficiently staffed and equipped to provide basic maternal health services. Whereas antenatal care attendance for at least one attendance was generally high (99.8%), uptake of four or more antenatal care services was low (61%). Uptake of delivery services was also unsatisfactorily low as a substantial proportion of women (35%) preferred home delivery to health facilities. The factors influencing uptake of antenatal care services were ethnic background and household wealth whereas maternal education, mode of travel to the nearest health facility and number of antenatal care visits influenced choice of facility delivery. Postnatal care attendance was mainly attributed to the desire to ensure safety and survival of infants. It is recommended that the government and households should put more emphasis to post-secondary education for women, improvement of transport infrastructure and equipping the current health facilities with qualified medical personnel and medical supplies.