Abstract: Introduction: Antenatal care, which is one of the pillars of safe motherhood, is health services provided by health workers for mothers during their pregnancy, which are implemented in accordance with the antenatal service standards set out in the Midwifery Service Standards based on 10 T. Objective: The aim of this study was to analyze the determinants of the organization that affect the performance of midwives in implementing Antenatal Care (10T) in a very remote area of Kupang Regency. Material and Method: The number of research samples was 72 samples in 2019 with data collection techniques using documentation studies, namely the checklist sheet. Data were analyzed using simple logistic regression analysis and multiple logistic regressions. Results: The results showed that the factors that significantly correlated between organizational factors and the performance of midwives in implementing ANC according to 10 T standards were the completeness of infrastructure (p = 0.0.046; OR = 2.800) and leadership (p = 0.006; OR = 4.185). The most significant determinant related between organizational factors and midwife performance in implementing ANC according to 10T standards in very remote areas in Kupang Regency was leadership (p = 0.033; OR = 3,340; 95% CI: 1.103-10,118). Conclusion: In integrated Antenatal Care services, health workers must be able to ensure that the pregnancy takes place normally, improve the mother's health status, carry out various health efforts, both promotive, preventive and curative and rehabilitative, seek services for pregnant women, help deliveries by health workers, able to detect early problems and diseases experienced by pregnant women, intervene adequately so that pregnant women are ready to undergo normal delivery, family planning counseling services, and reproductive health.