Introduction: Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. Availability of emergency obstetric and newborn care (EmOC) is a set of key medical and surgical intervention that target direct obstetric causes of maternal deaths and are known as Signal function. In Tanzania coverage of EmOC is very low especially in rural areas. Objective: The objective of this study was to assess the availability, utilization and quality of Emergency Obstetric Care in Meru District council which is located at Arusha Region Northern Tanzania. Methodology: A cross sectional survey of 20 health facilities providing delivery services for 24 hours and 7 days a week were purposefully selected including 2 hospitals, 8 health centers and 10 dispensaries was conducted from May to June 2015 WHO & AMDD data collection tools were used which assessed the availability, utilization and quality of services, Supplies, equipments of EmOC within the past three months prior to the interview. Proportions were used to summarize the data. Ethical approval was obtained from KCM-College ethical committees and permission from District Medical Officer of Meru District and Medical officers in charges from all selected health facilities. Results: One comprehensive emergency obstetric care facility (CEmOC) could provide all nine required signal functions while none of the Basic Emergency obstetric care (BEmOC) facilities could provide all the seven required signal functions. The proportion of birthing taking place at the facilities was 96.2%, the met need for emergency obstetric complication was 14.6%. Population caesarean section was 14.0%, Case fatality rate (CFR) was 3.1% and the stillbirth rate was 1.0%.Conclusion: Meru district has limited health facilities providing full functioning EmOC. All BEmOC facilities expected to provide basic EmOC, none of them performed all seven signal functions required for BEmOC facilities while two hospitals (CEmOC) expected to provide comprehensive EmOC only one provided all nine signal functions .Utilization of EmOC was found to be very high while met need for EmOC was far below the UN minimum requirement and caesarean section was between the acceptable range and Case fatality was above UN minimum recommended level. Key words: Emergency obstetric care, UN process Indicators, Maternal Mortality, Tanzania.