Objectives. This study examined the relationship of functional health literacy to self-reported health and use of health services. Methods. Patients presenting to two large, urban public hospitals in Atlanta, Ga, and Torrance, Calif, were administered a health literacy test about their overall health and use of health care services during the 3 months preceding their visit. Results. Patients with inadequate functional health literacy were more likely than patients with adequate literacy to report their health as poor. Number of years of school completed was less strongly associated with serf- reported health. Literacy was not related to regular source of care or physician visits, but patients in Atlanta with inadequate literacy were more likely than patients with adequate literacy to report a hospitalization in the previous year. Conclusions. Low literacy is strongly associated with self-reported poor health and is more closely associated with self-reported health than number of years of school completed.