Data from the district level household survey 2002 under the Reproductive and Child Health Project conducted in India has been used to examine the impact of utilization of antenatal care services on improvement in maternal health in the rural areas of Uttar Pradesh, India. Multilevel analysis shows that after controlling for other socio-economic and demographic factors, utilization of antenatal care services may lead to the utilization of other maternal health related services such as institutional delivery, delivery assisted by trained professionals, seeking advice for pregnancy complications, and seeking advice for post delivery complications. There is strong clustering of utilization of services within the primary sampling units (i.e. villages) and the districts.