Background: In 2021, about 4.5 billion people were not fully covered by essential health services. About 2 billion people face financial hardship, including 1 billion experiencing catastrophic out-of-pocket health spending globally. Objectives: to identify factors affecting utilization of Health care services among IDPs. Design: Cross-sectional study design. Site: Nasahblood and Ayah 4 Internally Displaced Persons. Participants: 271 households. Main Measures: The study used ordinal logistic regression analysis. Then, the data were exported to the STATA window for data analysis. Descriptive Analysis and ordinal logistic regression were used. Results. The research uncovered diverse patterns in healthcare service usage: 14.36% (n=26) displayed high usage, 12.16% (n=22) exhibited moderate usage, and 73.48% (n=133) showed low usage. For internally displaced individuals residing in Nasahablood and Ayah 4 regions of Hargeisa, Somaliland, accessibility substantially affected healthcare service utilization (P< 0.027, Coef = -1.403584). Similarly, affordability was found to have a significant adverse impact on healthcare service use within the same population (P>0.000, Coef=-2.272459). Moreover, socioeconomic factors, particularly gender, negatively influenced healthcare service utilization among the internally displaced persons in these areas (P< 0.026, Coef =1.77102). Conclusion. The research highlights the need for targeted interventions to improve healthcare access and affordability for displaced populations, ultimately aiming to enhance their overall health outcomes and well-being