Background: In developing countries, a large number of maternal deaths happen due to complications of pregnancy and delivery. In Ethiopia, the maternal mortality ratio had been 353/100,000 live births in 2015. Therefore, this study was conducted to assess the missed opportunity for maternal health care services in Eastern Ethiopia. Methods: A community-based cross-sectional study involving pregnant women in their third trimester and women who gave birth in the last five years was conducted between September to December 2017. Structured questionnaire was used for data collection and data were collected from a sample of 422 subjects in the districts. Descriptive (Univariable), bivariable and multivariable logistic regression analyses were conducted. Statistical tests were done at a level of significance of p < 0.05. Results: The result of this study showed that among 359 (85%) pregnant women who planned for ANC visit, 16 (4.5%) received ANC four or more times during their last pregnancies, the respondents (81.3%) claimed that they were taken care of by skilled delivery attendant during delivery, 18.5% of them said that they delivered at home and 71.1% of them received medical care after delivery. Women in the age group 15-24 years (AOR=??95% CI: 0.37, 3.74) and women who intended their last pregnancy (AOR=??95% CI: 0.11, 0.94) were significant predictors of unplanned home delivery. Conclusion: For optimal and effective interventions of maternal health services utilization, provisions should be made for better women’s education, family planning, job opportunity, and women empowerment; provisions should also be made for creating income-generating activities for women. Strengthening village women’s army wing, refreshing and enabling health extension workers and traditional birth attendants. What is more, optimal measures should be taken to discourage traditional practices such as female genital mutilation, polygamy, violence against women, and teenage marriage. Finally, free maternal and child health services should be advocated for so that the gap in maternal healthcare services is bridged.