To estimate the degree and pattern of utilization of institutional maternity services in a rural area of Zimbabwe, a cross-sectional study was performed in Gutu district about 250 kilometers south of the capital Harare. In August, 1991, 12 out of 43 wards in the district were randomly selected and in each ward about 40 women (in total 520) who had delivered in the previous 12 months were randomly selected and interviewed. There was a high degree of utilization of institutional maternity services by the women (96% 79% and 74%) for antepartum, intrapartum and postpartum care respectively). Women sought this care from a multiplicity of sources depending on a variety of social, geographical and service factors. Very few women (17%) had total pregnancy care at the rural health centre. There was a significant association between the actual place of delivery and nulliparity, whether the previous delivery took place at home, whether the family belonged to the Apostolic Faith sect, and whether the husband spent most time in urban area. For nulliparity, previous delivery at home and belonging to the Apostolic Faith sect the proportion of women delivering at home, at the rural health center/urban maternity clinic, and at hospital was statistically significant. The few maternity waiting shelters that were available lacked basic amenities and were unattractive to the mothers even though 65% either used them or could have done so if they were available.