Background: Antenatal care service is a care for pregnant women to improve health of the women and baby. Antenatal care service dropout is discontinuation of the Antenatal care service before at least having 4 Antenatal care visits. Antenatal care visit dropout is still continuing in developing country, including Ethiopia. Therefore the aim of this study is to determine antenatal care dropout and its associated factors among mothers who gave birth in the last three months in North Mecha district. Objective: To assess antenatal services drop out and associated factors among mothers who gave birth in the last three months in North Mecha district, Northwest Ethiopia, 2021GC. Method: Community-based cross-sectional study triangulated with qualitative study was employed from March 01 to 30/ 2021. The quantitative study was carried out on a total of 609 mothers who gave birth in the last three months in North Mecha district. Multi-stage sampling technique was used. Interviewer administered semi-structured questionnaires were used to collect data. Data entry was done by Epi data and analyzed by using statistical packages for social science (SPSS) version 23. Binary logistic regression model with bi-variate and multivariable analysis was used and the strength of statistical association was determined by using odds ratio with 95% CI and p-value <0.05. For qualitative part purposive sampling technique were employed to select study participants and data was collected by using focus group discussions, in-depth interview and then thematically data analysis. Results: This study found that the prevalence of Antenatal care dropout was (43%) with confidence interval (CI) (39.1, 46.8). Not knowing pregnancy danger sign [OR (95% CI): 1.93(1.298, 2.86)], Greater than and equal to 30 minutes waiting time [OR (95% CI): 1.528(1.045, 2.234)], Not satisfied in ANC service [OR (95% CI): 2.531(1.319, 4.857)] and distance taken greater than 1 hour to nearby health institution [OR (95% CI): 2.017(1.098, 3.704)], have a statistically significant association with Antenatal care dropout. In the qualitative study workload, being healthy, long distance, waiting time, dissatisfaction with the health service were most frequently mentioned reason behind their dropout. Conclusions: This study found high Antenatal care dropout rate. Factors which are associated with Antenatal care dropout were not having knowledge of pregnancy danger sign, waiting time taking >30 minutes, distance taking > 1 hour to get nearby health institution, and no satisfaction in the Antenatal care Service. Key words: antenatal care, antenatal dropout, factors, Ethiopia