Equity is an important policy objective in the health care field. The importance of equity in health care provision can be argued from various points of view. As a result governments in all countries attempt to provide health care systems that enable equal access for everyone. Zambia is no exception. In the health care reforms the objective of the national health strategy is to provide Zambians with equity of access to health care. We focus on access defined as the costs (both monetary and time) an individual incurs when visiting a health care facility. Using a survey of 900 households, this article explores equality of access to health care among Zambians. Four areas are compared: urban high cost, urban low cost, townships and rural areas. The results of the analysis indicate that there are inequalities among residential areas, especially between rural and urban areas. In particular these differences exist because of differing distances to the nearest health facility. Large distances make it very costly for rural dwellers to seek medical care, especially during the high season for farming. The analysis suggests that obtaining equality of access to health care poses a challenge for the Zambian Government.