Abstract Background Maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skilled birth attendant (SBA), and postnatal care (PNC) within 48 h of delivery. It is one of the essential strategies for reducing maternal and newborn morbidity and mortality. Therefore, this study aimed to assess the prevalence and factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam zone, Ethiopia. Methods A community-based cross-sectional study was conducted among six hundred twenty-one (621) women who gave birth in the last one year in Enemay district from February 25 to March 10, 2019. A simple random sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value