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Background: Health system that is chiefly financed by out of pocket expenditure can have varying impact on patients belonging to different income groups. The main objective of the present study was to assess the health-care utilization pattern and socioeconomic features of elderly who incurred catastrophic health expenditure. Materials and Methods: A community-based cross-sectional study was conducted employing multi-stage sampling technique to collect data from a total of 404 elderly residing in Lucknow district. Data were collected on health care utilization and related health care expenditure with by the means of a questionnaire. Results: Out of 404 elderly, 15.8% incurred catastrophic expenditure. Among all the study participants, 33.1% who sought in-patient care and 13.8% who sought exclusive out-patient care incurred catastrophic health expenditure. Conclusion: Proportion of those facing catastrophic expenditure was high among lower income group. Thus, patients who lie at the bottom of income pyramid need higher protection as compared to those who are at the top.