Since 2014 Indonesia has been implementing a new health service system based on tiered referral system. One of the expectation among others is to improve in time maternal care and reduce maternal mortality by 25%. The aim of the thesis was to assess perception of patients about tiered referral system for maternal health care in Dr. M. Djamil Padang hospital. Cross sectional study was conducted in the hospital between Feb 1 –May 31, 2018. Ethical approval were provided. Interview guidelines were prepared according to Rapid Assessment of Referral Care System (Cervantes et al 2003). Collected data were analyzed using Microsoft Excel and NVIVO software. Results indicated that distance and travel time were the main problem to go to the hospital. Accessibility and equity of health care services was good, referral letter could be easily obtained from primary health care. However administrative systems were too complicated, online registration systems were rarely used. Insurance card activation were also problematic. Approx. 16% of respondent were not satisfied with the health service provided by the hospital.