Background: Although fecundity is reduced in late reproductive ages, fetal and maternal complications and unwanted pregnancy in this age group is higher. Limited researches have focused on the pattern of contraceptive methods choices in women aged 35 and older. The aim of this study was determinants of contraceptive choices pattern in this age group and related factors in womenattending health centers of Ahvaz.Methods: In a descriptive –analytic study 384 women aged 35 years or older attending 6 health centers of Ahvaz city in 2011 were studied. Data was collected through filling a questionnaire by trained questioner. Data was analyzed by SPSS version 16. The frequency table and Chi Square test were used for data analysis.Results: The mean age of women was 39.1±3.4 years and the mean age of marriage 20.2±5.3 years. The most common contraceptive methods used in these age group women were condoms, oral contraceptive pills and tubal ligation, 31.3%, 22.7% and 19.3% respectively. Vasectomy was using only in 0.5% of participants. A significant association were found between use of less effective contraceptive methods and women’s age (p=0/011), age of marriage (p<0/001), BMI (p=0/001), gravida (p<0/001) and parity (p<0/001). Conclusion: This study determined that use of less effective contraceptive methods in this population is high. Due to the risks of unwanted pregnancy and maternal complications of pregnancy in this age, family planning education and counseling should be given priority in health centers.