Objectives: This study aimed to assess the relationship between dental care needs and dental service use in Korean elderly. Methods: Using the sixth Korea National Health and Nutrition Examination Survey, from 22,948 individuals, 1,572 (male 701, female 871) elderly individuals aged above 65 years were included in the study. All analyses were stratified by sex. Results: In males, the group with subjective needs was 3.74 (95% confidence interval [CI]: 2.58-5.41) times more likely to use dental services than the group without subjective needs. For females, the group with subjective needs was 2.17 (95% CI:1.57-2.98) times more likely to use dental services than the group without subjective needs. Conclusions: To conclude, the elderly with symptoms, used the dental services for pain relief and functional recovery. Fundamental efforts to improve oral health are needed, such as providing treatment, prevention and educational services, besides efforts to provide treatment-oriented dental services. Further research is needed for the middle and elderly individuals who are in the blind spot of the existing policy.