India has a strong base of ancient indigenous systems of medicine and its national health policies and programmes have consistently promoted the integration of Indian Systems of Medicine (ISM) into the country’s official health system. Realizing the safety and efficacy of ISM drugs, the Department of Indian Systems of Medicine and Homoeopathy (ISM&H) has suggested their use for certain women’s health problems and during pregnancy. Although the Government of India has attempted to integrate ISM through the country’s contemporary health programme of Reproductive and Child Health (RCH), utilization dynamics from the clients’ perspective is little understood. This study shows that, at least in urban areas, for the majority of women’s health problems biomedicine is regarded as the first choice, failure of which leads clients to seek treatment from ISM as a final resort. Nevertheless, women showed a preference for ISM treatment for certain specific health problems, strongly backed by a belief in their efficacy. Of the predictors that positively influenced women’s choice of ISM treatment, ‘strong evidenced-based results’ was found to be the most important. Women’s preference for ISM is dependent on the availability of competent providers.