Based on data from the National Sample Survey Office’s surveys on healthcare, this study critically evaluates the impact of the National Health Mission on improving utilisation of maternal healthcare services in Bihar, which had very poor maternal and child health outcomes at the start of the mission. In particular, it investigates factors affecting the utilisation of maternal care services and choice of facilities between the pre- and post-NHM periods; assesses the success of the Janani Suraksha Yojana in enhancing institutional delivery, particularly in public facilities; and estimates the out-of-pocket expenditure on maternal care in the pre- and post-NHM periods and identifies factors affecting such expenditure levels.