Profound changes in the Brazilian health system have occurred in the past few decades. Data from two cross-sectional population-based studies carried out in 1992 (n = 1,657) and 2007 (n = 2,706), among individuals from 20-69 years, were compared aiming to describe changes in Pelotas, Brazil. Prevalence of consultations in the past twelve and three months were calculated and stratified by gender. The most recent consultation was analyzed according to place and reason. Utilization in the past year increased from 69.8% to 76.2% (p < 0.001) and in the past three months from 39.5% to 60.6% (p < 0.001). There was an increase in use of authorized services, except for black/brown people who mainly continued using public services (69% in 1992 and 61.8% in 2007). Among men, preventive consultations increased more than ten-fold. In the past fifteen years, most of public demand was absorbed by authorized services. This absorption was not even, black/brown users remained in public services. The greatest increase in preventive consultations by males occurred in the low risk age group (20-39 years).