Despite governments' and international development partners' efforts, maternal deaths remain prevalent in Somalia, with approximately 621 deaths per 10,000 live births. Most complications resulting in these deaths are amenable to the use of quality obstetric care services, especially antenatal care (ANC) services. While the prevalence and correlates of prenatal care use are well documented, limited studies have focused on antenatal care uptake in Garowe, Puntland state of Somalia. This study aims to highlight factors associated with antenatal care services use among women aged 15–49 in Garowe, Nugaal Region, Somalia. We used a descriptive cross-sectional design. A cluster sampling technique was used to select 384 participants for the study. Logistic regression was computed to identify independent factors associated with four ANC visits. Respondents’ average age was 30.2 years, with a range of 16 to 48 years. More than half (56.8%, n=218) of the respondents did not complete four ANC visits. Multivariable analysis established that those who lack insurance, (adjusted odds ratio (aOR)= 6.07, 95%CI: 3.41 – 10.80, p<0.00), used public transport (aOR = 3.68, 95%CI: 1.31 – 10.32, p =0.013), walk to the health facility (aOR =4.0, 95%CI: 1.80 – 8.77, p =0.001), agreed that women discourage ANC attendance in the community (aOR = 3.72, 95%CI: 1.63 – 8.49, p =0.002) and had used TBAs (aOR =13.13, 95%CI: 6.81 – 25.29, p<0.001 were likely to not complete four ANC visits compared to their counterparts. While the WHO now recommends eight antenatal care visits, most pregnant women in the study setting did not complete the previously recommended four antenatal care visits, largely due to social and economic factors. There is a need to provide support to women in the community through financial support and ensure that ANC services are affordable and accessible to increase uptak
