Health services are considered to be of good quality if customers’ expectations and perceptions are well balanced. Determinants confirming customers’ expectations will lead to satisfaction, while factors disconfirming it will result in customers’ dissatisfaction, reduced compliance to physicians’ treatment and deterioration in overall disease management. A cross-sectional comparative study was carried out from September till October 2008 to determine population satisfaction with health services provided by the public health clinics in Selangor. A total of 3840 respondents from the urban Health Clinics (HCs) and 4768 respondents from rural HCs were selected applying multi-stage random sampling from 54 HCs in nine districts from Selangor. Self-administrated questionnaires formulated by adopting SERVQUAL method based on modified five dimensions plus four dimensions of Clinics Corporation were used . Results showed the proportion of satisfaction among the population towards services provided by the public HCs was high at 86.1%. From X2 bivariate analysis; satisfied respondents were significantly from Indian and Chinese ethnic community more than the Malays, more among the less educated, the older age category (more than 33 years old) and males’ were slightly more satisfied than females. Patients who visited HCs more than three times were more satisfied than one time visitors. Occupation, marital status and HCs urban-rural locality were not significantly associated with customers’ satisfaction level. All dimensions showed high satisfaction level especially on treatment outcome, except on health care workers (HCWs) caring and professionalism domains. Working as a team was slightly higher in the urban areas compared to rural area. Overall, the SERVQUAL score of all dimensions were higher among the urban respondents albeit not significant. Clients’ perceptions were generally higher than expectations reflecting the high satisfactions among clients at 86.1%. Much improvement needs to be put into training HCWs to be more caring and adapting a professional attitude towards clients. Clients’ satisfactions in the urban and rural HCs were almost equal and did not reflect a decrease of health services priority in the rural areas.