Primary Health Centers are the cornerstone of rural healthcare in India. Updating these centers to provide round the clock services to reduce the unmet need for maternal healthcare; is an important objective of National Rural Health Mission since 2005. Yet, functionality of PHCs to provide 24x7 services remains poor due to several health system issues. The present cross-sectional facility based study evaluates the functioning of rural 24x7 primary health care facilities in 3 districts of Gujarat for obstetric care performance and its predictors. The study used pretested questionnaire for collecting data from all PHCs of study areas in 2012-13. Obstetric care performance was measured as number of deliveries conducted in last 3 months. Current study found that the obstetric care performance is independent of infrastructure or logistics situation but highly dependent availability on the skilled human resource. There is urgent need for a systematic study to evaluate performance of public health facilities along with use of routinely collected data to make the system efficient.