Background: By the end of 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, Hubei province, China. In Saudi Arabia, the government applied prompt preventive measures against coronavirus disease 19 (COVID-19). COVID-19 associated restrictions have been affected the antenatal care (ANC) services that made careful surveillance of the pregnant women health requirement to protect them from COVID-19 infection. The current study was conducted to assess the COVID-19 pandemic effect on ante-natal care utilization among primigravida women in Asir region, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted targeting all females with their 1st pregnancy during COVID-19 pandemic. The questionnaire covered pregnant females’ demographic data, medical history, COVID-19 infection history, ante-natal care visits. Final questionnaire was distributed among woman attending antenatal care clinics at primary health care centres (PHCCs) and Abha Maternity and Children Hospital clinics in Asir region during the period from December 2020 to December 2021 Results: A total of 555 women attend to antenatal care clinics participated in the study. Primigravida women, who got pregnant during the COVID-19 pandemic were included. Exact of 114 primigravida women meet the inclusion criteria. Participants’ ages ranged from 21 to more than 40 years with mean age of 24.6 ± 9.4 years old. Ante-natal care visits of 1st pregnancy women during a period of quarantine in Asir regions. Exact of 90 (78.9%) pregnant females were compliant to ANC visits during COVID-19 pandemic. A total of 63 (70%) of these visits were in the private sector while 21 (23.3%) were at the governmental hospitals and 18 (6.7%) at the PHCCs. Conclusion: The current study revealed that pregnant primigravida females were adequately adherent for the ANC visits during COVID-19 pandemic especially those with multiple pregnancies. The most settings provided ANC visits were the private sector with reported good pregnancy outcome.