Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, components of antenatal care are key to reduction of maternal mortality. We explored women’s receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, in Open Data Kit software were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Analyses were done using STATA version 15.1.Results: Women’s median (range) age was 26 (15-45) years, majority were married [87.0%, (423/486)], their main occupation was housewives (stay home mums) [45.1%, (219/486)] and never studied beyond seven years of education [69.1%, (336/486)]. Over three quarters of women who attended the nationally recommended four focused ANC visits did not receive all seven components of care at least once during the visits [76.4%, (107/140), P