Objective (s): The Iranian population is rapidly aging, and a large volume of services are provided in comprehensive health service centers with the aim of reducing the costs and care burden of the elderly population, therefore, identifying the factors affecting the elderly's not visiting the health service centers is of great importance. This study was conducted to determine and compare the reasons for the elderly's not visiting the comprehensive health service centers from the perspective of elderly residents of Esfarayen. Methods: This investigation is a cross-sectional descriptive-analytical study. Its statistical population was all elderly residents of Esfarayen city. Initially, 290 elderly people who had not visited comprehensive health centers in the past two years were reviewed by census method. Then, they responded to demographic questionnaires concerning the reasons for the elderly’s not visiting comprehensive health centers, which were psychometrically tested by Masumi et al. (2022). The collected data were analyzed using descriptive and analytical statistical tests, including mean, standard deviation, frequency, Spearman, Mann-Whitney, and Kruskal-Wallis in the SPSS-27 statistical software. The significance level in all tests was considered to be 0. 05. Results: In this study, 245 elderly people (59. 6% female, 40. 4% male) with a mean age of 72. 25±9. 37 years participated. According to the results, the most common reason for the elderly participants not to visit comprehensive health service centers was the inadequate physical conditions of comprehensive health service centers, and the least common reason was insufficient awareness and knowledge about the provision of health and medical services. Conclusion: To improve health services and increase older people's access to healthcare, service providers must pay close attention to existing barriers and seek comprehensive and effective solutions to address them. In this regard, paying attention to the opinions and needs of older people and their participation in the process of designing and implementing health services can lead to continuous and sustainable improvements in their access to health care.