This study assesses the utilisation of school health services in Ibadan North-West Local Government Area, Oyo State, Nigeria, with implications for primary healthcare among school children and the prevention of early-life preventable diseases. The research objectives include determining the level of school health service utilisation among secondary students in public and private schools, investigating barriers affecting utilisation, and examining the association between school type and service utilisation. A descriptive cross-sectional research design was employed, sampling 300 students aged 10-19 from a population of 37,396 in Ibadan North-West Local Government Area. The study utilized a multi-stage sampling procedure and a self-structured questionnaire with sections on socio-demographic characteristics, utilisation assessment, and barriers. The instrument's validity was established through content and face validity procedures. Results indicate a higher utilisation of school health services in private schools compared to public schools, highlighting a deficit in human and material resources for qualitative school health programs. Weak collaboration between the health and education sectors was detected, contributing to suboptimal standards and dissatisfaction among beneficiaries. Factors such as logistical challenges and changing living areas were identified as potential contributors to poor health program implementation. Recommendations include intensified efforts by school management boards to ensure service utilisation, the creation and maintenance of healthy school environments, and increased family involvement in school health service policies.