Divisions between the public and private health sectors in South Africa have resulted in inequalities in access to each of these sectors. Using the KwaZulu-Natal Income Dynamics Survey, the aim of the paper is to explore the patterns and determinants of health-seeking behaviour among black Africans. The results show that the majority of respondents consulted public health services. Despite this, it was possible to determine that income-based poverty and access to medical aid were the most significant predictors of healthcare choice. Poverty was related to other predicting factors such as employment, level of education and household size. Surprisingly, a sizable proportion of the poor without access to health insurance were using private health services. Although the reasons for this could not be determined, this presents opportunities for further research.