To evaluate the contraceptive choices and usage of women in rural Aba, Southeastern Nigeria, and identify factors influencing their choice and usage of modern contraceptive methods.The records of new and old acceptors of family planning methods between 1 November 2005 and 31 October 2007 at the reproductive health clinic of a primary health care center in Osisioma Ngwa local government area in the suburb ofAba, were reviewed and analyzed. Qualitative data was collected by in-depth interviews (IDIs) of 88 out of 188 clients whose records were analyzed.Majority of the clients (71.8%) accepted injectable hormonal contraceptives followed by the intrauterine contraceptive devices (IUDs) (14.4%). Sub-dermal contraceptive implants were accepted by 6.9% of the women and female sterilization by 3.2%. The oral contraceptive pills and the male condom were the least accepted by the clients. Only 2.1% of the contraceptive acceptors were adolescents. The modal age of the acceptors was 30 years and the average age 33.4 years while the age range was 18-51 years. The average parity was 4.7 while the modal parity was 5. The indication for contraception was child spacing in 30% of the clients and permanent limitation of the family size in 70% of the clients. Attitude of the women to the various methods of contraception was an important factor influencing contraceptive choices of the women interviewed.The study has shown that the most commonly used contraceptive method in rural Southeastern Nigeria is the injectable hormonal contraceptives. Strategies to increase contraceptive use in rural Nigeria must include improving delivery of correct and adequate information about the available contraceptive methods.