Objectives The purpose of this study was to evaluate employees' utilization of occupational health services in three Dutch companies in which the access to such services (open consultation hour, summoning and periodic health examination) is organized differently. Accessibility to occupational health services was considered to be adequate if workers with work-related health problems were reached.Methods For a random sample (N=911) utilization figures were determined. For a second, nonrandom sample (N=313) with an overrepresentation of employees with work and health problems, interviews were conducted with regard to health and work problems and motives for utilizing occupational health services.Results Workers with different profiles of work and health problems were reached through different types of access to occupational health services. To a large extent, the utilization of occupational health services is determined by the organization of its access.Conclusions Accessibility of occupational health services is an important prerequisite of effectiveness and therefore a serious object for health policy and evaluation.