Due to higher rates of chronic illness and disabilities than other age groups, elders use a disproportionate amount of medical care services. Identifying patient-directed goal of care is an important strategy to optimize health outcomes. This study aimed at identifying the pattern of elderly utilization of health services and their satisfaction about care rendered. The study was conducted at three health service facilities namely, Geriatric Clinic [GC], General Outpatient Clinics [OPCs] at Alexandria Main University Hospital and Smouha Pension Clinic [PC] at the Health Insurance Organization. A systematic random sample of elderly attending these facilities during a two month period was conducted and included 350 elderly patients. An interview questionnaire was applied to all elderly attendants to collect data about the socio-demographic characteristics, their utilization pattern of health services, and their satisfaction about the services rendered. The results revealed that the main reason for choosing the facilities was the fact that the service was free of charge. The majority of the elderly utilized their facilities twice/month. More than 2/3 of the patients at GC, PC [72.9%, 73.8%, respectively] and 46.2% of patients at OPCS were completely dependent on the current facility for medical care. Private facilities were the main alternative for those who utilize other sources of medical care. Highest assessment of care rendered as regards technical care and information given was encountered among elderly at PC and lowest at GC for most of the items. On the other hand, the lowest mean satisfaction score for most of the items of care rendered was encountered among elderly at PC and highest among elderly at GC, and the overall satisfaction score was significantly higher among elderly at GC. Significant predictors for frequency of utilization of the current facility were the level of education, number of chronic diseases, and utilization of other sources of medical care. On the other hand, significant predictors for the total satisfaction score were, utilization of other source of medical care, adequate examination time, given details about the current condition, and given instructions about the drugs prescribed.