Cost analysis can be an important element and it help to sort out important economic issues. The economic constraint is one of the factors that hinder service utilization among rural women attending urban health although there is Maternal Incentive Scheme, households often have to pay a too large share of the indirect costs of maternity services, or do not seek care because of it. Methods: Cross sectional study design which is community based with quantitative method were used for this study to

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... assess the indirect cost of institutional delivery under safe motherhood program in Pokhara Metropolitan from Jan 2019 to June 2019. Study population were the mothers who delivered at health facilities having safe motherhood program within the 6 months preceding the survey. Probability Proportional to size sampling method was adopted with face to face interview among the care takers of mothers. Reliability and validity was maintained by applying different strategies carefully developing tools, pretesting, double entry and validation. Data entry, management and analysis was done with Epi Data and SPSS (20 version) Software. Results: In this study majority more than half (54.4%) of the mothers were between 25-34 years. Majority of the participants were male and nearly half of the respondents were belonged to Janajatis (51.5%). More than one fourth (29.6%) of the mothers were from the highest quintile. Median expenditure for indirect cost was NRs 4900 which ranges from NRs 500 to NRs 47000. Conclusions: From the study we can conclude that existing Aama Surakshya Program can save only a few expenditure of mothers there should need to review this demand side financing scheme and also need to address the main barriers for service utilization i.e. indirect cost of institutional delivery.