The purpose of this study was to examine the health service utilization patterns of Ethiopian immigrants and refugees in a random sample of 342 adults residing in Toronto. The results suggested that 85% of the study participants used one or more type of health services, most often from a family physician. However, only 12.5% of them with a mental disorder received services from formal healthcare providers, mainly family physicians. While the presence of somatic symptoms was significantly associated with increased use of healthcare (p < 0.05), having a mental disorder was associated with lower rate of health service use (p < 0.05). These findings suggest that family physicians could play important role in identifying and treating Ethiopian clients who present with somatic symptoms, as these symptoms may reflect mental health problems. Further research is necessary to determine the reasons for the low rates of mental health services use in this population.