While the last two decades have been marked by sustained high economic growth, they have also witnessed growing concern about unequal gains in health outcomes. This is partly due to factors pertaining to ? nancing, provisioning, and governance of health services in both, the public and private sectors. Several studies as well as government policy have recognized the lacunae in the present state of health services and the multiple axes of inequities that characterize it. The ? rst section of the paper provides an overview of the inequities in health outcomes and their variation across regional, social, and economic groups. It seeks to explain these variations by focusing on health services as a determinant of the health status. It identi? es and analyses the key drivers of inequities in health services, namely, weak public provisioning and rampant commercialization. These factors have implications for equity and cost across income quintiles, especially for those who are socio-economically marginalized.