Introduction Ethiopia, an ancient country with a long history of independence- perhaps as long as the evolution of the homo sapiens- is also the seat of some of the world’s ancient civilizations in record. The Axumite, Lalibela and other early civilizations centered in Ethiopia have gradually declined over the succeeding centuries to be followed by hundreds of years of isolation, introversion and stagnation that has persisted to the modern era. Hence, this once great country and its peoples have missed on most of the dramatic changes of recent civilization including the numerous benefits of the industrial revolution of the eighteenth century. At the turn of the twentieth century, this once great civilization found itself among the world’s “backward” nations. The only significant exception was that its people have maintained their independence; an admirable, historic and astounding feat of great import to Ethiopians and people of African descent. This centuries old socioeconomic isolation and backwardness led to a poor state of health of its people without access to the benefits of modern medical amenities. Women’s health including their sexual and reproductive health (SRH) was and still is markedly poor; often compounded by gender bias and harmful traditional practices. This has led to a very high rate of maternal mortality and morbidity that has persisted to the present day. Modern nation building initiated during the reign of Emperor Theodros and intensified by Emperor Menelik at the turn of the twentieth century gradually led to the introduction of Ethiopia to modern medicine; a process that has yet to reach the whole of the country. Although some expatriate medical practitioners have come to Ethiopia beginning from the sixteenth century, they have often catered for the royal families of the times, their entourage and the populace in the immediate vicinity. Access to organized modern health care for the population began with the introduction of the first hospital in Ethiopia, the Russian Red Cross Hospital (predecessor of the current Menelik II Hospital in Addis) in 19061. Although detailed information could not be found, it can be assumed that some form of obstetric-gynecologic care was part of the medical care provided at this hospital. Expatriate physicians provided some form of modern health care mostly to the populace of Addis Ababa during the first half of the twentieth century, including the five years of Italian occupation. The evolution of modern maternity care in Ethiopia can be reviewed under three phases which include the early decades of the twentieth century, when maternity departments and hospitals were established in the country (mostly in Addis Ababa). This period included the first eight decades of the twentieth century. The establishment of the Graduate Program of the Department of Obstetrics and Gynecology of the Faculty of Medicine, Addis Ababa University was twenty seven years ago in 1980 2. It was a turning point in the expanded provision of specialized maternity care in Ethiopia. It has led to the increase in the number of gynecologists in the country from the handful of expatriates and foreign trained Ethiopians working mostly in Addis Ababa at the time, to the hundreds working in the capital as well as in the various parts of the country today. Establishment of the Ethiopian Society of Obstetricians and Gynecologists (ESOG) in 1992 marks the third important milestone in specialty level SRH services, as it signaled the initiation of an organized, public health commitment to take up the challenge of improving the SRH status of the peoples of Ethiopia. It is heartening to see that this third and most important phase has gained momentum over the years as ESOG prepares to go forward with new initiatives to achieve its vision and missions.