Background :The factor of maternal health care utilization is complex and varying from region to region. However, identifying their cause assist health planners to maximize effort and is the fundamental step for intervention strategies in the study area and other similar settings Objectives: The aim of this study was to measure the maternal health service utilization and associated factors at Dale-Wonsho health and demographic surveillance site of Hawassa University ,Ethiopia, 2019. Methods:A community based cross-sectional study was conducted on 691 women of reproductive age in Dale-Wonsho health and demographic surveillance site of Hawassa University by using multi-stage sampling technique. Structured interviewer administrated questionnaire was used to collect the data. The data was entered to Epi data and exported to SPSS for analysis. Bivariate analysis done first and variables with p-value <0.25 were considered as candidate for multivariable analysis. Result: The response rate is 98.6%. The utilization of ANC, institutional delivery and PNC among the women’s of reproductive age was 69.1%, 52.1% and 32.7% respectively in the study area. Odds of being utilization of ANC increased 4.72 times for mothers who had a formal education(AOR=4.72, 95% CI=2.82-7.9; P=0.001) than mothers who did not have it. Moreover, the receiving of model household training (AOR=8.52; 95% CI = 5.5 -13.1; P = 0.001) and being richest wealth index groups (AOR = 0.16; 95% CI =0.06-0.41; P=0.001) were found to be a significant contributor to the mothers being utilize ANC. Institutional delivery was more likely to occur in women who had used ANC as compared to did not use (AOR = 5.9; 95% CI= 3.87 – 9.17; P= 0.001). Presence of information about PNC (AOR= 3.6; 95% CI = 2.18-6.2; P= 0.001) and autonomy of mothers to make decision on health matters (AOR=6.13, 95% CI=3.8-9.72; P= 0.001) showed that a significant association with a women’s PNC utilization. Conclusion: The Utilization of maternal health service in the study was found to be lower than the targeted zonal and health sectors transformation plan. Maternal and paternal education, autonomy of the mothers to make decision on the health matters, wealth index and having a plan on current live birth were responsible factors for the low level coverage of maternal health care for women’s in the studied area.