Background: Optimum antenatal and postnatal care services are recognized to be among the most effective interventions to reduce maternal and newborn morbidity and mortality. However; optimum antenatal care (ANC) and postnatal care (PNC) service utilization among young women in Africa is very low, especially in rural zones. Therefore, this study was conducted to determine the magnitude of optimum ANC and PNC services utilization and the factors associated, in the Eastern Zone of Tigray, Northern

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... Ethiopia. Methods: Using a cross-sectional study design, 352 young women aged 15 to 24 were interviewed. Among those, 101 and 100 were eligible and included for studying optimum ANC and PNC service utilization, respectively. Multivariable logistic regression models were performed to identify independent determinants of the two outcome variables (optimum ANC and PNC utilization). Results: Optimum ANC and PNC services utilization was reached in 75% (95%CI: 64.50-84.20) and 16% (95%CI: 9.00-24.00) of the cases, respectively. Being older (20-24 years old vs. 18-19: AOR=9.21; 95% CI: 1.62-52.25) and knowing the availability of adolescent and youth friendly health service (AYFHS) (AOR= 4.01; 95% CI: 1.08-14.89) were significantly associated with optimum ANC service utilization. Furthermore; knowing the availability of AYFHS (AOR=10.81; 95%CI: 1.57-71.18) and having the right to decide about her own health care spending (AOR=6.16; 95%CI: 1.22-31.05) were significantly associated with optimum PNC service utilization. Conclusion: In rural zones in Tigray, PNC services utilization is far away from the optimum, while ANC service utilization is closer, even if a significant number of young women did not receive optimum ANC services. The presence of an AYFHS and its knowledge are shown to be related to an increase of optimal services utilization and hence interventions need to be designed accordingly.