Objective. The objective of the present study was to verify the quality of adult and older adults health care in Primary Health Care (PHC) services in the four health macro-regions of the State of Mato Grosso do Sul, 2018. Methods. A quantitative survey was carried out in which the municipalities participating in the study included the four macro-regions following the Director Regional Plan (DRP). In this study, the quality of care was verified using the validated version of the PCAT-Br for adult and older adults users over 18 years of age and professionals. The macro-regions were compared between PHC attributes and between professionals and users in the State of Mato Grosso do Sul. Analysis of variance (ANOVA) and paired student t-test was performed. STATA v.14.2 software (College Station, TX, USA) was used for the analyses. Sensitivity analysis was done to compare the macro-regions and socio-demographic characteristics. Results. Eight hundred twenty-five users and 424 professionals participated in the study. According to users, the Accessibility attribute was the attribute with the worst performance in all macro-regions. There were significant differences between the perception of users and professionals in all attributes evaluated and regional differences between the perception of users among the four macro-regions analyzed. Conclusions. There was a difference in perception between users and professionals, and there were macro-regional differences between PHC attributes. Therefore, it is necessary to strengthen PHC care networks in the State, mainly considering the users' perspective.