The morbidity rate is one indicator to measure the degree of health. In 2015, the morbidity rate for the elderly in Indonesia was 28.62%. However, the percentage of urban elderly morbidity rate of 26.89%. This study aims to determine factors related to the utilization of health services by the elderly in the Public Health Service Area in Koto Tangah District, Padang City. The research design is quantitative with a across sectional study. The population in this study is elderly who are life in the Public Health Service Area in Koto Tangah District. The number of the population is 3901 elderlies aged 60 years. The sample number is 94 elderlies. The results of the research showed 44.7% of the elderly did not utilize health services. 34.0% of the elderly with a lack of knowledge, 12.8% of the elderly do not have health insurance, and 40.4% of the elderly have a lack of perception about illness. The statistical test obtained the knowledge and perception of illnes, p value are 0,000 respectively but health insurance ownership p value is 0,184. The results of the analysis showed that there was a significant relationship between knowledge and perception of illness to the utilization of health services. There is no significant relationship between health insurance ownership to utilization of health services.