Provincial inequalities in maternal and child health care are explored with data from the 1998 South African Demographic and Health Survey (SADHS). Most provinces have made considerable progress in ensuring relatively equitable access to immunization and to opportunities for pregnant mothers for consultations with medically trained personnel, be it for antenatal care or during delivery. However, the public-private divide in health care persists, as do inequalities in contraception usage. Furthermore, provinces have not made similar progress, with inequalities being consistently worse in Kwazulu-Natal, Mpumalanga, the Eastern Cape and Gauteng. Given the importance of health care in achieving development, government and health authorities have to continue to make concerted efforts to expand health care delivery to the poor, to address the obstacles the poor face in accessing health care services, and to increase the efficiency of health care delivery.