BackgroundAntenatal care (ANC) in developing countries is among strategies aimed at reducing maternal mortality yet its quality and utilization are still low. Only about 60% of pregnant mothers in Uganda attend at least four ANC visits despite it being one of the strategies to curtail maternal mortality. The satisfaction of pregnant mothers with ANC services is associated with increasing their access and utilization. Therefore, there is need to evaluate the extent to which pregnant mothers are satisfied with ANC services and the associated factors.MethodsA cross-sectional analytical study employing quantitative methods of data collection and analysis was conducted. Data was collected from 384 participants using interviewer administered semi structured questionnaires. Bivariate analysis using the Pearson chi-square (χ2) test was conducted to determine the individual and health facility factors associated with satisfaction with ANC services among pregnant women. Multivariate analysis was performed on the variables that were statistically significant (p < 0.05) at bivariate analysis using logistic regression model to control confounding and determine independent factors associated with satisfaction with ANC services among pregnant women.ResultsOf the 384 pregnant women enrolled, 259 (67.4%) were satisfied with ANC services. Multivariable logistic regression analysis revealed that knowledge about ANC services (AOR=4.2, 95% CI: 2.23–7.81; p < 0.001), waiting time of less than one hour (AOR=2.8, 95% CI: 1.30–5.99; p = 0.009), positive attitude of healthcare providers (AOR=5.9, 95% CI: 3.13–11.25; p < 0.001), and availability of ANC commodities (AOR=3.0, 95% CI: 1.53–6.06; p = 0.002) were independently associated with satisfaction with ANC services.ConclusionImproving maternal knowledge on ANC services, reducing waiting times, ensuring availability of essential ANC commodities, and promoting respectful provider-client interactions may enhance women's satisfaction with ANC services. Strengthening these aspects of care could improve ANC utilization and contribute to better maternal health outcomes.