The aim of this paper is to test whether the condition of “double insularity”, -i.e. being resident in one of the five small islands of the seven Canary Islands- has any effect on equity in the utilisation of public health care services. Data on 4.320 participants from the 2004 Canary Health Survey were considered for this analysis. A zero inflated negative binomial (ZINB) model was estimated for each of the four health services analysed (general practice services, specialist services, emergency services and hospitalisations), controlling for area of residence, for health care need and for socioeconomic and demographic characteristics, measured at the individual level. The results show evidence that, in general, the “double insularity” condition represents a limitation in the utilisation of public health care services, therefore to the detriment of the residents in the small islands.