Objective: This study aimed to gather evidence of progress made in the provision of emergency obstetrics and newborn care (EmONC) services in Zanzibar. Methods: This cross-sectional study was conducted in 83 health facilities in ten districts of Unguja and Pemba islands in Zanzibar in 2018 using the validated Averting Maternal Death and Disability (AMDD) program module. Results: Proportion of non-EmONC facilities is lower compared to 2012 (35% vs. 55.7%). Moreover, partially BEmONC facilities have increased compared to 2012 survey (58.7% vs. 28%). Only 2.5% and 3.8% provided CEmONC and BEmONC respectively. Concerning population size, EmONC availability is met at only 33.3% while a similar number lacks Comprehensive EmONC.