This article describes the results of a follow-up study of primary health services in rural Iceland during one week in October 1981. The initial study, which was conducted in September 1974, was the first major study in Iceland of medical services outside hospitals. The aims of the present study were to collect data on primary health services, and to compare results with the study in 1974. Data from 58 doctors and other personnel in 31 health centres are included in the analysis. The annual average number of contacts with the health centres was estimated at 4.9 per inhabitant, median 4.8. Comparable figures in 1974 were 4.6 and 4.5, respectively. Each doctor on average served 1,303 inhabitants, range 674 to 2,051. The most common reasons for contacts were: preventive measures, respiratory diseases, and diseases of the musculoskeletal system. The most common actions taken were, in order of frequency: prescriptions, advice, and minor examinations. Referrals to specialists, measured as the percentage of all contacts, were 2.8% in 1981, compared to 3.1% in 1974. Referrals to hospitals and other health institutions were also less frequent in 1981. On average, physicians worked more than 50 hours per week, and over half of them carried out additional hospital duties.