Background: Previous primary studies reported controversial findings on the association between predictors and antenatal care (ANC) service use. Therefore, we aimed to provide pooled predictors of ANC service use among women of reproductive age in Ethiopia.Methods: All observational studies done in Ethiopia between 2002 and 2022 were included in this review. Studies were systematically searched from PubMed, Medline, CINAHL, EMBASE, Google Scholar, and Google. We conducted a database search from June 1-31, 2023. The Newcastle-Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). The review was registered in the PROSPERO register with the registration number CRD42022322940. All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to get the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger's regression test. Results: A total of twenty-two studies with a total sample size of 25,671 were comprised for this review. Based on the NOS checklist assessment, we classified eight studies as low quality. The identified predictors of ANC use were highest wealth rank (AOR 1.92 [95% CI: 1.53 - 2.31]), formal women education (AOR 2.40 [95% CI: 1.75 - 3.06]), formal husband education (AOR 1.49 [95% CI: 1.36 - 1.66]), women age > 20 (AOR 1.75 [95% CI: 1.47 - 2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21 - 1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11 - 1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28 - 1.91]), women autonomy (AOR 1.42 [95% CI: 1.23 - 1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47 - 3.79]). Conclusions: Several predictors have increased the ANC utilization, like wealth status, women's and their husbands' education, older/increasing women's age, media exposure, maternal knowledge about the pregnancy complications, planned pregnancy, women's autonomy to decide on household health care, and positive husband attitude about the ANC service utilization. Thus, the government and stakeholders should create women-focused economic reforms such as encouraging women's involvement in rural saving and credit cooperative organizations and productive safety net programs to increase their income, advocate ANC in mass media, and increase the mechanism of ANC service messages to reach the largest women of reproductive age groups.