evidence: Antenatal care (ANC) aims to reduce maternal and neonatal morbidity and mortality through a variety of interventions. The World Health Organisation (WHO) recommends a minimum of four ANC checkups provided by a Doctor, an Auxiliary Nurse Midwife (ANM), or a Nurse. Ideally, a woman should have her first ANC checkup either when she first notices a missed period or during the first three months of pregnancy. ANC registration in India is done during the first visit of the expecting mother to a healthcare facility. Registration thus serves as an indicator of a pregnant woman’s first contact with the healthcare system. Early and regular ANC check ups have been shown to improve pregnancy outcomes and have thus attracted the attention of policymakers. Effective ANC thus is the backbone of optimal maternal and child health. [...] Analysis of the HMIS data reveals that coverage of antenatal registrations and antenatal visits across India’s districts is not uniform. Promisingly, at least half of the registrations were early and at least half of the pregnant women received four or more ANC check ups in most districts. However, pockets of poor performance exist, notably concentrated in the North East region of the country. Specific and targeted measures to bridge these gaps are necessary if India is to achieve the SDGs on maternal and child mortality by 2030.