Antenatal care (ANC) is critical for ensuring the health and well-being of both mother and child during pregnancy. In rural Bangladesh, despite efforts to improve maternal health, ANC utilization remains suboptimal due to multiple influencing factors. This study explores the key determinants affecting antenatal care utilization among pregnant women in rural areas from a nursing perspective. Using a cross-sectional descriptive design, data were collected through structured interviews with pregnant women in selected rural communities. The findings highlight that socio-economic status, educational level, cultural beliefs, accessibility to health facilities, and support from family members significantly influence ANC attendance. Additionally, nursing interventions focusing on education, counseling, and community outreach play a vital role in promoting ANC utilization. Understanding these factors enables nurses and healthcare providers to develop targeted strategies to improve ANC coverage, ultimately reducing maternal and neonatal morbidity and mortality in rural Bangladesh. The study emphasizes the need for strengthened nursing roles and community-based approaches to enhance maternal healthcare services.