Abstract: Objective: To investigate the current status of community health service utilization among older adults in the community and the factors associated with frequent use, thereby providing a basis for optimizing community health service strategies and improving service utilization rates and quality of service for older adults. Methods: From March to April 2024, a stratified random sampling method was used to select 363 older adults aged ≥60 years in the service area of the Weifang Community Health Service Center in Pudong New Area, Shanghai, for a questionnaire survey. The questionnaire was designed based on Anderson’s theory of health service utilization behavior and related model frameworks. It covered predisposing factors of community health service utilization (including gender, age, educational attainment, occupational category, health beliefs, and living arrangements), needs factors (including self-perceived health status and the presence and number of chronic diseases), enabling factors (including main type of health insurance, proportion of household income spent on health management and medical services, enrollment in contracted family doctor services, knowledge of the contracted family doctor service program, familiarity with family doctor team members, and level of trust in the family doctor team), as well as utilization of community health services over the past six months (including service types and frequency of use). A multivariable logistic regression model was used to analyze factors associated with the utilization of community health services. Results: Among the 363 older adults, women (67.22%) and those with a high school education (47.44%) accounted for a higher proportion. 67.22% of the older adults lived with a spouse, 46.83% had two or more chronic diseases, and 82.92% had signed up with a family doctor. Overall, 82.64% (300/363) of older adults had used at least one community health service over the past six months. The three most frequently used services were: basic general practice services; long-term prescriptions, extended prescriptions, and health consultations under the family doctor contract system; and traditional Chinese medicine (TCM) services. The three services with the lowest overall utilization rates were: community ward and palliative care services; integrated medical and elderly care services; and home and outreach visits provided by family doctor teams. Compared with older adults without stable employment, older adults with a stable occupational background were more likely to use community primary care services frequently (OR = 1.841, 95% CI: 1.002-3.372); compared with older adults with low physical health beliefs, older adults who reported better self-rated health were less likely to use basic general practice services frequently (OR = 0.470, 95% CI: 0.281-0.788). Compared with older adults with poorer self-reported health, older adults with stronger beliefs regarding physical health were more likely to use public health services frequently (OR = 2.603, 95% CI: 1.050-6.421); compared with older adults with low levels of trust in family doctor teams older adults with greater trust in family doctor teams were more likely to use public health services frequently (OR = 5.014, 95% CI: 1.442-17.418). Conclusion: Older adults in Weifang Community, Pudong New Area, Shanghai, have relatively high rates of community health service utilization and self-reported enrollment in contracted family doctor services. Efforts should be made to strengthen the promotion and outreach of community-based inpatient and palliative care services, integrated medical and long-term care services, and home and outreach visits by family doctor teams; service processes should be optimized and accessibility improved to increase the utilization of these services by older adults. Special attention should be given to older adults with unstable employment, poor self-rated health, low physical health beliefs, and low trust in family doctor teams, to encourage them to make frequent use of basic general practice care and public health services such as follow-up for chronic diseases.