Primary Health Care is the first point of contact for most Nigerians with respect to the health care system, but the level of clients’ access and utilization are mostly plagued with distinct problems across geographic locations, thereby impeding sustainable development of rural communities. The aim of this study is to evaluate the intriguing relationships existing among location, distance, and the utilization of government-owned primary health care facilities (PHCF) by residents in Isiala-Mbano, Imo State. A stratified random sampling method was used to select a sample population of 475. Questionnaire and interviews were used to elicit information from the respondents, while geospatial tools were used for mapping the spatial distributions of three Health Posts and fourteen Health Centers. Analyses of data using descriptive statistics, geographic information system, nearest neighbour analysis, Pearson product moment correlation coefficient, and student’s t-test revealed that: (i) PHCF’s are randomly distributed within the study area as indicated by the Nearest Neighbour Index of R = 1.164. (ii) Estimated Euclidean distances from users’ houses to nearest PHCFs showed that 66.5 percent of the users live within 1 km and 33.5 percent live between 1 km to 2.3 km from the nearest PHCFs. (iii) Average Nearest Neighbour Distance gave 1.3708 km with good topography. (iv) The ratio of population to health center gave 11,972:1, implying that Isiala-Mbano is adequately served by primary health care centers, but the levels of utilizations were generally very low due to lack of doctors and valid drugs for patients. A test of Hypothesis showed that there is no significant relationship between the distance of primary health care facilities and the level of utilization in the study area. Hence, this study recommended timely health care facility reform through the supply of essential drugs and employment of specialized manpower sustainably to attend to patients in the study area.