This study investigates the utilization of antenatal care (ANC) services and their impact on maternal and birth outcomes in Techiman Municipality, Bono East Region, Ghana. The research aims to assess the patterns of ANC use, identify factors influencing ANC utilization, and examine the relationship between ANC use and pregnancy outcomes. A cross-sectional design was employed, collecting data from 400 pregnant women through structured questionnaires. The data were analyzed using logistic regression to determine the predictors of ANC utilization and its effects on birth outcomes. The results indicate that 68% of women attended at least four ANC visits. Key determinants of ANC utilization included socio-economic status, educational level, and spousal support. Despite the implementation of a free maternal healthcare policy, significant barriers such as transportation costs, long waiting times, and cultural beliefs were identified. The findings reveal a positive correlation between adequate ANC attendance and improved birth outcomes, including reduced incidences of low birth weight, preterm births, and neonatal mortality. Women who attended at least four ANC visits experienced significantly better maternal health and birth outcomes compared to those with fewer visits. The conclusion highlights the necessity of targeted interventions to address the barriers to ANC utilization. Recommendations include enhancing public awareness, improving healthcare infrastructure, and fostering supportive environments for pregnant women. By identifying critical factors influencing ANC uptake and their impact on maternal and birth outcomes, this research provides valuable insights for policymakers and healthcare providers aiming to improve maternal health services in Techiman Municipality and similar settings.