Background: Antenatal care refers to care provided by skilled healthcare professionals to pregnant mothers to ensure optimal health for both the mother and baby throughout the pregnancy period. It promotes health promotion, risk identification, prevention, and management of pregnancy-related illnesses to avoid health problems in both the fetus and mother. Quality antenatal care consists of delivering essential services to every pregnant woman and her fetus, while also providing more specialized care for those who need it. Methods: A facility-based cross-sectional study was conducted from November 1 to November 30, 2024, involving 406 pregnant women attending antenatal care at a public health facility located in Dilla Town. Data were collected using a structured questionnaire and observational checklist. Study participants were selected using a systematic random sampling method. Trained data collectors conducted the exit interviews. The collected data were entered into EPI Data version 3.1 and subsequently analyzed using SPSS version 26. Bivariable and multivariable logistic regression analyses were performed. The results were presented as adjusted odds ratios with 95% confidence intervals. A p-value of less than 0.05 was used to declare statistical significance in all inferential analyses conducted in this study. Result: This study indicated that about 52% (95% CI: (51.5%–52.5%)) of pregnant mothers had received quality ANC services. The frequency of ANC visits and satisfaction with ANC services were significantly associated with the quality of ANC services provided. Pregnant women who attended a second visit or more had 2.2 times greater odds of receiving good-quality ANC compared to those who only attended their first ANC visit (AOR = 2.24, 95% CI: 1.43 3.51). Furthermore, participants who were satisfied with the ANC service had approximately 6.2 times higher odds of receiving quality ANC in comparison to those who were dissatisfied (AOR = 6.21, 95% CI: 3.48–11.08).