en تخصصي Special مقالات اصيل Original Article <strong>Background</strong><br> The demand for cosmetic surgery is on the rise worldwide, making it the common form of surgery globally while the use of cosmetic surgery being exponentially high in Iran. The aim of this study was to investigate inequality in the use of cosmetic services and surgery (CSS) among Iranian households concerning demographic and socio-economic characteristics.<br> &nbsp;<br> <strong>Methods</strong><span dir="RTL"></span><br> This study used data of 38960 Iranian household from the income-expenditure survey of the statistical center of Iran (SCI) in 2019. Concentration index (C) was used to measure inequalities in the use of CSS. Microsoft Excel sheet 2019 was used to extract the data, and the analysis was performed using Stata statistical package version 14.2.<br> <strong>Results</strong><br> Households with female head, with single head, households with 3 - 4 people, headed with undergraduate education person, households with insurance coverage, with higher socio-economic quintiles, rural households and residents of northwestern Iran were accounted for the highest use of CSS. Also, according to the decomposition analysis, wealth and education level are the two main factors in creating inequality, with wealth, &nbsp;having the highest positive share (88.11%) and education level having the most negative share (-5.26%) in creating measured inequality.<br> <strong>Conclusion</strong><br> The use of CSS is more concentrated in well-off households in Iran. As the resources of health system are limited, the government and the policy makers should have defined plans with regards to CSS use especially taking factors like socioeconomic status and education status of target groups in to account. Concentration index, Surgery, Social economic, Cosmetic 73 80 http://wjps.ir/browse.php?a_code=A-10-724-2&slc_lang=en&sid=1 Sajad Darzi Ramandi 100319475328460012471 100319475328460012471 No 1- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Kamran Irandoust 100319475328460012472 100319475328460012472 No 2- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran Reza Hashempour 100319475328460012473 100319475328460012473 No 3- Vice-chancellor’s Office in Treatment Affairs, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Hamid Talebianpour 100319475328460012474 100319475328460012474 No 4- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Jafar Yahyavi Dizaj 100319475328460012475 100319475328460012475 No 4- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Moghimi 100319475328460012476 100319475328460012476 No 4- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali Kazemi-Karyani 100319475328460012477 100319475328460012477 Yes 5- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.