Background: Primary healthcare facilities are designed to serve as the first point of contact within the healthcare system. However, older adults often bypass primary healthcare facilities despite their relative affordability especially in low-resource settings.

Objective: This study was designed to examine the extent of primary healthcare facility utilization among older adults in Ekiti State and to identify factors militating against adequate utilization.

Methods: This hospital-based cross-sectional study involved community-dwelling older adults aged 60 years and above residing in Ekiti State. Data were obtained through structured interviewer-administered questionnaires to assess healthcare utilization, out-of-pockets expenditures, awareness of primary health centre locations, and perceived service availability. Descriptive and inferential statistics were carried out.

Results: Utilization of primary healthcare facilities was low despite incurring lowest mean healthcare expenditure. Major barriers to utilization included poor awareness of the location of primary healthcare centres, lack of medical doctors, and unavailability of essential medications. The lower cost of care alone could not pull older adults towards primary healthcare centres.