BACKGROUND: Socio-economic inequalities in health may be due to differential uptake of preventive and therapeutic medical services. OBJECTIVES: To examine socio-economic position and self-reported use of six preventive services in a cohort of older British women. METHODS: Women randomly selected from general practice age/sex registers in 23 towns were examined from 1998 to 2001. Of all, 3652 women aged 62-83 years completed a questionnaire in 2003 assessing preventive service use. RESULTS: Women from manual social classes were less likely to have recent flu vaccinations [odds ratio (OR) 0.85, 95% confidence interval (CI) 0.74, 0.98] and dental (OR 0.42, 95% CI 0.36, 0.49), eye (OR 0.77, 95% CI 0.67, 0.88) or chiropody examinations (OR 0.88, 95% CI 0.77, 1.01). Manual social class was not related to having recent blood pressure or cholesterol checks. CONCLUSIONS: Among older British women, preventive services for cardiovascular disease are not socially patterned. However, those from lower socio-economic groups are less likely to have recent flu vaccinations and dental, eye and chiropody examinations.