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Accessing a health care facility is a common issue in Lao PDR. The aim of this study is to understand the cultural beliefs and practices affecting antenatal care (ANC) utilization among adolescent pregnant women in Hatpang village, Pak Ou district, Luang Prabang province, Lao PDR. The research design applies qualitative methodology. Data collection methods were ethnographic interview and participation observations from August to October 2013. The findings showed that women's overall cultural perception regarding ANC services was poor. The quality of care was due to lack of health staff technical competence, lack of culturally sensitive health care service, language barrier, and lack of convenience in terms of time and traveling. Cultural beliefs related to pregnancy and child birth of individuals are the natural state of pregnancy; risk during pregnancy is determined by the sized of the fetus which can be managed by food restriction. Regarding gender practices, women carry on with traditional double responsibility of working hard in the rice field, and working in the home.