Dissertation (MSc Midwifery)Client satisfaction is an essential determinant of the quality of services. At a time when efforts to reduce maternal mortality have been stepped up, mothers satisfaction with institutional delivery services is important for the wellbeing of the mothers and newborns. Little was known on the factors associated with postnatal mothers satisfaction with institutional delivery services in Manyara Region. A hospital-based analytical cross-sectional study design using a quantitative approach was conducted. A simple random sampling using lottery technique was used to obtain a sample size of 329 postnatal mothers and all participated in the study during data collection. An interviewer administered a structured questionnaire was the main method of data collection. Data were analyzed by Statistical Package for Social Science (SPSS) version 20. Multivariate and logistic regression was applied to identify factors associated with postnatal services utilization. Of all 329 postnatal mothers who had institutional delivery, 188(57%) were satisfied with institutional delivery while 141(43%) were not satisfied with institutional delivery services. Predictors of satisfaction were age [20-29 years (AOR=3.149, 95% CI 1.169-8.481 p=0.023), 30 years and above (AOR=4.421, 95% CI =1.451-13.474, p= 0.006)] and high perceived benefit towards institutional delivery (AOR= 1.936, 95% CI 1.190-3.150 p=0.008). This study found that substantial numbers of post-delivery mothers were not satisfied with health institutional delivery services. Young women and unemployed were less likely to be satisfied with health institutional deliveries. The study recommends an interventional study which will come up with cost-effective strategies to improve satisfaction with health facility delivery.