Background: Accessibility and utilization of health care play a significant role in preventing complications during pregnancy, labor, and the early postnatal period. However, multiple barriers can prevent women from accessing pregnancy and neonatal care. The aim of this study was to explore the multifaceted barriers that inhibit women to seek maternal and newborn health care in Thatta, Sindh, Pakistan.Methods: This study employed an interpretive research design using purposive sampling approach. Pre-tested semi-structured interview guides were used for data collection. The data were collected through eight focus group discussions with men and women, and six in-depth interviews with lady health workers and analyzed through thematic analysis. Findings: The study identified individual, socio-cultural, and structural level barriers that inhibit women from seeking maternal and newborn care. Individual barriers included: mistrust towards public health facilities, and inadequate symptom recognition. The two identified socio-cultural barriers were: aversion to biomedical interventions, and gendered imbalances in decision making. The structural barriers included: prohibitively expensive transportation services, and ineffective referral systems. Conclusion and Suggestions: Increasing the coverage of healthcare service without addressing the multifaceted barriers that influence service utilization will not reduce the burden of maternal and neonatal mortality. As this study reveals, care seeking is influenced by a diverse array of barriers that are individual, sociocultural, and structural in nature. A combination of capacity development, health awareness, and structural interventions can address many if not all of these barriers.