This study examined the relationship between socio economic status and utilization of healthcare services in Obi Local Government Area of Nasarawa State Nigeria. The study is rooted in persistent disparities in healthcare access in rural Nigeria where income, education and employment continue to shape health seeking behaviour despite policy efforts to expand coverage. The objectives were to assess the effects of income level, educational attainment and employment status on healthcare utilization. The study was anchored on Andersen’s utilization of health services theory which explains healthcare use through predisposing, enabling and need factors while acknowledging structural constraints. A descriptive survey research design was adopted. Data were collected from 372 adults using structured questionnaire and in-depth interviews selected through multistage sampling. Quantitative data were analysed using descriptive statistics while qualitative data were analysed thematically. The findings revealed that low income significantly constrained access, frequency, quality and continuity of healthcare utilization leading to delayed treatment, self-medication and reliance on traditional care. Educational level influenced health literacy for formal healthcare and preventive service use although its effect was mediated by economic capacity and sociocultural factors. Employment status enhanced healthcare utilization through income stability and access to health insurance while unemployment reduced regular check-ups and preventive care. The study concludes among others that socio economic status remain a critical determinant of healthcare utilization in Obi Local Government Area operating through both individual and structural pathways. It recommends, among other measures, enhancing financial protection mechanisms, expanding community-based health insurance, implementing targeted health education programs, and extending health coverage to workers in the informal sector to ensure more equitable access to healthcare.