Ensuring that immigrants receive adequate healthcare is essential when addressing health inequalities in society. The objective of this chapter is to analyze immigrants’ use of the healthcare system compared with natives of the Spanish region of Aragon, who have been shown to be representative of the Spanish population in terms of age, gender, and immigration status. In addition, the Aragon Health Service is part of the Spanish National Health System, which is based on the principles of universality, equity, free access, and financing fairness, and is mainly funded by taxes. This is a retrospective observational study of the EpiChron Cohort in 2014 in Aragon, Spain. We developed a descriptive analysis of the use of different levels of care and prescription drugs. The incidence rate ratios for healthcare system use were also calculated. Immigrants’ global use of healthcare services and prescription drugs was significantly lower than that of Spanish-born. Even when considering differences in age, gender, and morbidity, immigrants showed a lower use of healthcare services than Spanish-born, except for emergency room services and unplanned admissions. Immigrants living in urban areas used the healthcare system less frequently than natives, except for emergency room services. In turn, they used healthcare services less in rural areas than in urban areas. With few exceptions, nonprimary care users did not have more emergency room visits or unplanned hospital admissions than primary healthcare users. These differences may be partly explained by the healthy migrant effect, but other factors should also be considered. Designing health policies that take these factors into account could improve access to the healthcare system and offer truly universal healthcare coverage.