There was no data on the impact of falls on health service utilizations in Chinese older adults. The present study investigated the impact of falls on health service utilizations in community-dwelling Chinese older adults in Hong Kong. A population-based sample of 1517 older adults aged 65 years or over was recruited. Baseline assessment at home and then the occurrence of falls as well as health services utilizations were monitored for 1 year. The prevalence of falls, single fallers and recurrent fallers were 26.4%, 19.4% and 4.75%, respectively. 95.6% (n=1450) of the subjects completed the 1-year follow-up. Fallers had significantly greater numbers of hospitalizations, visits at specialist doctor clinics and emergency department than non-fallers (0.46+/-0.09 versus 0.23+/-0.03, 1.98+/-0.25 versus 1.37+/-0.11 and 0.40+/-0.04 versus 0.21+/-0.002, respectively; p<0.05). Based on current Hong Kong public health care cost and population data, we calculated that fallers would consume approximately US$ 71 millions (HK$ 552 millions) public health care dollars more than non-fallers did annually in Hong Kong. A population-based falls prevention program is recommended to reduce falls, fall-related health care service utilizations and health care expenditure.