Understanding online user behavior is essential for designing user-friendly consumer health Web sites. Transaction log analysis (TLA) provides a way to extract aggregate data about online behavior. This paper describes prevalent user navigation trends using TLA methods at ClinicalTrials.gov. Preliminary results suggest that users typically access low-level pages directly from Web-based search engines and consumer health sites/portals. A pilot user study is presented to illustrate a complementary research method that might be integrated with TLA to provide a multidimensional view of online health information-seeking behavior. Implications of the observed navigation behavior on the design of consumer health Web sites from TLA and users studies are discussed.