Objective: To identify determinants for the utilisation of delivery services by pregnant women in Rwanda, considering individual and demographic, socioeconomic and health service factors. Design: A secondary data analysis of the third (2005) Rwandan Demographic Health Survey (RDHS III) was conducted. Women who had at least one live birth during the fiveyear period prior to the survey were included in the analysis. Bivariate and multivariate analyses were undertaken. Results: A total of 5235 participants fulfilled the study eligibility criteria and were included in the analysis. Although more than 90% of participants attended an antenatal service, only 30% delivered at a health facility. The predictors of a home delivery were higher parity (OR=5.01, 95% CI: 4.11-6.31 for parity of 6 or more), place of residence (OR=1.86, 95% CI: 1.55-2.23 for rural women), lower household wealth (OR=4.37, 95% CI: 3.43-5.56 for the poorest quintile), lower education level (OR=3.61, 95% CI: 2.73-4.76 for no education), none or one antenatal care visit (OR=3.62, 95% CI: 2.76-4.74 for one antenatal care visit) and the lack of antenatal counselling about pregnancy complications (OR=1.83, 95% CI:1.40-2.40). Conclusion Utilisation of maternal health services, particularly health facility delivery services, remains low in Rwanda. The promotion of at least four standard antenatal care visits, as well as efforts targeting specific risk groups, such as higher parity, rural and less educated women living in poorer households are critical if the country wishes to reduce maternal and neonatal mortality and morbidity