PurposeResponsiveness is one of the key components of good governance and one of the ultimate goals of health systems. The purpose of this study was to investigate the importance and level of health system responsiveness (HSR) from the perspective of people with disabilities in Iran.Design/methodology/approachThis cross-sectional study was carried out using multi-stage sampling in Kurdistan province in 2020. Of 1,067 participants, 889 and 520 had used outpatient and inpatient services, respectively. HSR questionnaire developed by World Health Organization was completed.FindingsThe dimensions of prompt attention (97%) and social support (81%) were the most and the least important dimensions for the respondents, respectively. In general, 43.6% of the respondents reported a “poor” status for HSR.Research limitations/implicationsDesigning targeted interventions to increase the level of health system responsiveness, especially with a focus on dimensions that are important to respondents but have weak performance, such as communication, confidentiality and autonomy, is suggested based on the findings of this study.Originality/valueThis is the first study performed on HSR from the perspective of people with disabilities in Iran. The findings of this study could be of interest to health policy makers to understand and improve healthcare experiences for marginalized populations globally.