Background: Maternal mortality remains a major public health challenge worldwide. Postnatal care is important to treat any complications arising from the delivery, as well as to provide the mother with important information on how to care for herself and her child. Hence, postnatal care is the most crucial intervention for improving maternal and child health.

Methods: Community based cross sectional study.

Results: 27.7% who gave birth in the last two years preceding the survey had attended at least one postnatal care follow up. Women who attended antenatal care visit, who mentioned at least one pregnancy danger sign and who gave birth at health facility were more likely to utilize postnatal care service. Women who reported pastoralist as their occupation were associated with lower odds of postnatal care service utilization as compared to those who had other occupational status.

Conclusion: Nearly three women in every eleven had attended at least one postnatal care visit. Therefore, strengthening pastoralist–based maternal health facilities could be important to improve postnatal care service utilization in Afar Regional State.