Background: Antenatal care is the care that women receive during pregnancy to ensure a healthy outcome for women and newborns. In spite of its clear importance, such services continued to be important determinants of maternal mortality and morbidity throughout the world. Methods: A case study was conducted in Higher 2 Town Health Center, using client exit interviews of 265 clients who came to the health institution. In addition, 10 observations of client-provider interactions, document reviews of 246 clients' documents selected by systematic random sampling technique, and 5 in-depth interviews of the focal persons were conducted. Quantitative data were analyzed using SPSS for windows (SPSS 16.0). Qualitative data were categorized into major thematic areas and presented as narratives in triangulation with the quantitative results. In each evaluation dimension, indicators were used to judge the quality of antenatal care services. Results: Most of the minimum required basic resources recommended by World Health Organization were available in the study site. But there were incomplete sets of laboratory reagents and shortage of some drugs. Comprehensive history was recorded for 93.4% of clients. Only 34.3% of clients received prescriptions for iron supplementation. Majority (94.6%) of the clients were satisfied with the accommodations of antenatal care service. The compliance of the health care providers towards routine laboratory investigations ranged from 25.4% to 50.1%. Conclusions: The overall quality of the service was judged as fair (69.5%). Majority of the clients were satisfied with accommodation of ANC services. However, the availability of laboratory reagents and drugs remained to be challenges. Providers' compliance towards standard basic investigations was also far below World Health Organization recommendations and judged as critical. Thus it is recommended that responsible bodies should strive to improve provision of supplies and compliance of the care providers to step-up the quality of care at president capacity level.