Urban slums in Zanzibar, Tanzania, face significant challenges in accessing quality healthcare services. Understanding perceptions and attitudes towards these services is crucial for improving health outcomes. A mixed methods study combining qualitative survey analysis with semi-structured interviews was conducted among 150 participants in Zanzibar. Quantitative data were collected through online surveys, while thematic analysis of interview transcripts provided deeper insights into respondents' perspectives. Participants expressed significant concerns about the availability and quality of healthcare services, particularly regarding access to essential medications and timely consultations. Over 70% reported difficulties in accessing healthcare facilities due to distance and financial constraints. The mixed methods study revealed a nuanced understanding of residents' perceptions and attitudes towards healthcare services in urban slums of Zanzibar. Healthcare providers should prioritise the establishment of more accessible and affordable healthcare centers within these communities. Additionally, community engagement initiatives are essential to address misinformation and improve patient satisfaction. urban slum, healthcare perceptions, qualitative survey, mixed methods study