Background: Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent men living in Matara district, placing a heavy burden on the healthcare system. Objectives:This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional medicine (TM) use among older men having NCDs. Methods: A convenient sampling was used to recruit men who were > 40 years (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as TM use. Logistic regression was also employed to investigate possible associations between reported conditions and TM use or medical pluralism. Findings: Within the study sample, 72.4 % self-reported an NCD. Of those with self-reported NCDs, 33.2 % had one, and 39.2 % had two or more NCDs. Those with NCDs usually visited Government health facility (88.1 %), relied on doctors (95.2 %) and other health professionals (28.1 %) for health information, and mostly used TM to manage diabetes (42.4 %). Medical pluralism was mostly evident among men (with NCDs) suffering from headaches. Participants with dental problems (OR: 4.34, 95 % CI: 2.51–6.37), headaches (OR: 2.89, 95 % CI: 1.56–6.32) were more likely to use TM. Conclusion: Self-reported NCDs with co-morbidities were prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. TM use was not very common. However, among those who used TM, medical pluralism was prevalent. Family history was the most common reason for TM use, with many TM patients using these for treatment of a health condition.