Background and significance: Safe motherhood starts before conception with proper nutrition and healthy life style. Lack of or low quality reproductive health services are the leading causes of maternal morbidity and mortality worldwide. Objectives: to describe the reproductive health pattern in rural Assiut regarding age at marriage, consanguinity, number of children, use of antenatal, natal and post natal and Family planning care and sources of health services and to determine the underlying socio¬-demographic factors. Methodology: A household survey was carried out in October through November 2009 in 3 districts in Assiut governorate namely; Abnoub, Sahel Seleem and Sdefa districts (3 villages in each district) to estimate patterns of reproductive health among females in reproductive age (15-¬ 49 years) The present study used cluster sampling and structured interview using questionnaire for data collection. Results: A total of 2331 females in reproductive age (15- ¬49) were interviewed, of them 1 640 (70.4%) were currently married. The average age at marriage was 1 9.4 years. Out of 1 505 married women, about 54% have first or second degree consanguinity and 9% were pregnant at the time of the survey. The mean number of pregnancies was 4.8. The majority (88%) of women received antenatal care during their last pregnancy and about two thirds of them (64.4%) received it from rural health unit. More than 50% of deliveries were at home and about one half (46%) received post natal visits. At the time of the survey, contraceptive use among interviewed women was about 45%. The commonly used methods were IUDs, followed by pills then injectables (20.4%, 1 2.6%, and 9.6% respectively). The vast majority of women (94%) were satisfied with various services provided. The main causes of dissatisfaction were deficient medications and long waiting time. Conclusion: Consanguineous marriage, relatively young age at marriage, low contraceptive use and high fertility remain a problem in rural Assiut and indicates the need for application of more rigorous counseling programs.