Abstract: Objective To explore the impact of urbanization on the residents' health service needs and utilization for the purpose of providing references for health making-decision by analyzing the difference of health service needs and utilization in semi-urban residents,urban residents and rural residents. Methods The residents in the three economic zones of Chengdu were selected by stratified ration sampling and interviewed with the questionnaire. Results The two-week morbidity rate, hospitalization rate, and non clinical visit rate of semi-urban residents were higher than those of other people, and the chronic disease prevalence rate of urban residents was higher. Age, employment status, and the urban-rural identification were the main influential factors of two-week morbidity rate and chronic illness prevalence. After the related factors were controlled, the urban-rural identification was not the impact factor of the health service utilization. Conclusion The urban-rural integration development has promoted the health service accessibility and narrowed the disparity of health to some extent between urban and rural residents. However, the semi-urban residents should be caught a great deal of attention as a special group, and given more employment assistance.