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Introduction: For reducing maternal deaths, institutional delivery (ID) is a recognized strategy. India has introduced a combination of performance-based incentive and conditional transfer under Janani Suraksha Yojana to boost ID. The present study aims to find out factors deciding ID in rural India. Methods: Data were from nationally representative National Family Health Survey 4 (2015–2016). States were compared individually and in groups. Correlation was used for analysis. Results: Number of antenatal care visits (r = 0.807), early registration (r = 0.820), and consumption of 100 or more iron-folic acid tablets (r = 0.765) were significantly related to ID. Northeast states performed poorly, Nagaland being the worst performer (24% ID). Conclusion: Strategy for encouraging ID should focus around components of antenatal checkup, particularly in Northeast states.