Dissertation (MA Sociology)Zanzibar is a part of the United Republic of Tanzania which initiated health sector reform in 2002, in order to ensure the availability of equitable high quality health care services to all people of different age. According to the Population and Housing census (2012), elderly population rose from 5 percent up to 7.3 percent. This make up approximately 19 percent of all those experienced disability in Zanzibar. Data show that, the number of disabilities in Zanzibar rose from 16 percent in 2009 up to 19 percent in 2012. This indicates that health needs for the older people were not met in the Isles, including the usage of Preventive Health Services. Therefore, the aim of this study was to examine factors influencing utilization of Preventive Health Services among elderly people in the urban settings in Zanzibar. Andersen Behavioral Model of Health Service Use manipulated to examine factors influencing the use of Preventive Health Services among elderly. Data for this study were gathered through surveys; whereby, questionnaires were allocated among 85 elderly living in the Urban District, in the Urban West Region, in Zanzibar. FGD was used to 14 elderly from Sebleni Nursing Homes while structured interview was used to two (2) government officials, and 4 doctors. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 15.0 and Microsoft office 2007. The results have shown that both sexes of the elderly people in Zanzibar had limited access to the essential Preventive Health Services. This was due to lack of awareness and negative attitude towards Preventive Health Services. Data also have revealed that as the age increased the usage of Preventive Health Services decreased. Furthermore, the study results revealed that, health insurance played a key role in an individual ability to obtain health care services.