Objective: Living overseas in another culture, the retirees need to adapt to new environment but often this causes difficulties, particularly among the elderly who are having health problems. This study aims to examine factors affecting healthcare service utilisation among Japanese retirees in Malaysia. Design: We conducted focus group discussions with Japanese retirees and in-depth interviews with government officials, travel agents, hospital managers and Japanese interpreters in the selected private hospitals. Guided by the Andersen Healthcare Utilisation Model, we analysed the data using the directed content analysis method. Setting: We interviewed participants at Japan Clubs and their offices. Participants: They were thirty Japanese retirees who live in Kuala Lumpur and Ipoh, and eight officers representing services providers. Results: Three themes, health beliefs, medical symptoms and health insurance were identified which align with the theory. Additionally, language barriers, voluntary health repatriation to Japan and receiving psychological/psychiatric support and treatment were found as unique factors which influence healthcare utilisation among Japanese retirees. Conclusions: The healthcare utilisation of Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia.