Background information: It is estimated that 287,000 women worldwide die annually from pregnancy and childbirth-related conditions, and 6.9 million under-five children die each year, of which about 3 million are newborns. Most of these deaths occur in sub-Saharan Africa. According to WHO, a woman in Somalia has one in 10 chance of dying for pregnancy or childbirth-related causes. This study assessed the availability, accessibility, and quality of emergency obstetric and neonatal care services in Somalia. Methods: From February to April 2019, a descriptive, cross-sectional health facility survey was conducted in 9 purposively selected referral Hospitals and 28 randomly selected health centers in Somalia. Multistage, cluster sampling method was used to make sure that we have subjects from all administrative areas of Somalia. The health facility tools developed by the Averting Maternal Death and Disability program were adapted for local use. A structured questionnaire and observation methods were used for data collection. Descriptive, bivariate, and multivariate logistic regression analyses were conducted. Results: Only 10.8 % of the health facilities qualified as functioning comprehensive EmONC (Emergency Obstetric and Neonatal Care) facilities and 29.7 % were Basic EmONC Facilities. 35.1% were partially performing basic EmONC and the remaining 24.3% were not providing EmONC. Neonatal resuscitation was performed in 62 % of health facilities that were surveyed. The study found that there was limited availability of human resources in all visited health facilities. Conclusion: There is a need to strengthen human resource capacity at both Health centers and Hospitals through training of health care providers as well as the provision of essential drugs, equipment, and supplies to improve EmONC services, and to reduce workload at the comprehensive EmONC facilities and increase geographic access