Previous studies show that knowledge of prenatal care in rural areas remains low that affects to bad behavior, so developing health promotion models is needed to improve prenatal care knowledge, attitude and behavior. This study aimed to develop health promotion model of prenatal care in rural area based on needs assessment. Study was conducted on June 2015 by qualitative approach involving first 16 pregnant women in third trimester with risky pregnancy as key informants and 16 family members living with them and know their daily life, 27 midwives and 3 religious leaders as additional informants. Data collection techniques were in-depth interviews and observation for pregnant women and family, then focus group discussion for midwives and religious leaders. Analysis used was Miles and Huberman model by data reduction, data display and conclusion. Based on needs assessment, health promotion media is needed by book for pregnant women with attractive design that features images, colors and complete explanation. Book is selected because of pregnant women's preference and needs, characteristics of rural areas and infrastructure availability. Prenatal care materials need to be added from book containing child and maternal health including prenatal checkup by midwives, danger pregnancy signs, causes, consequences, prevention, recommended and unrecommended food, breast care ways, pregnancy exercise and fetal development. Health promotion methods are lectures and discussions in pregnant women's class.