Qualitative descriptive study that investigated the accessibility of elderly people with physical disabilities to health services in primary care, from the perspective of users, health professionals and managers. System and policy Services 18 interviews with seniors and using semi-structured questionnaires with 17 managers and three health professionals, between June and December 2010 were performed for data analysis used the dialectical hermeneutics, emerging categories. health challenges and contradictions; Meeting the needs of the elderly with disabilities discourses and practices; Accessibility barriers barriers to care to the elderly. Situations, being old and have a disability, are vulnerable situations; existing weaknesses in senior care with physical disabilities in primary care against the principles of the Health System, which are universality, fairness and integrity.