Background:Maternal health program is one of the most important programs in Iran primary health care (PHC). Considering the necessity of its continuous quality improvement, the present study was designed to identify the challenges of Iran maternal health program from the midwives' perspectives. Methods: This is a qualitative study with 27 midwives working in East Azerbaijan province PHC system. The sampling method was purposeful and the inclusion criterion for participants included at least 5 years of experience in the maternal health program. The researchers conducted eight individual and group unstructured interviews and the content analysis method was used for data analysis. Results: This study identified 9 themes, 16 subthemes, and 39 items related to the challenges of the maternal health program from the midwives' perspectives. The main identified themes were human resources, information management, service continuity, cultural barriers, legal and administrative barriers, care facilities, medical equipment, monitoring and evaluation, and geographic access. Conclusions:The study results indicated that there are significant challenges to the maternal health program, which implies the urgent attention of the managers and policymakers to designing and implementing effective interventions.