Integrated programs make the task of concentrating preventive actions for specific groups easier. However, health services must firstly be accessible, an essential condition for the population to use them. Hence, the objective of this study was to identify municipalities with the highest needs of accessibility of preventive actions through information synthesized in an accessibility index. This cross-sectional study considered eight metropolitan municipalities of Monterrey, Mexico and 323 individuals sampled at random. We measured attendance for at least one preventive action the year before the survey, including vaccination, diabetes or hypertension diagnosis, and cervical or breast cancer among women. The accessibility index consisted of use and access barriers, quality and resource indicators standardized using Z-scores. Ninety-nine percent had attended health services for some preventive action. The municipality with the highest unmet need was Santa Catarina (Z -6.9) followed by Apodaca (Z -1.5) and Benito Juárez (Z -1.2). San Pedro registered the highest unmet need concerning economical access barriers (Z -3.5), whereas Apodaca was not good enough with quality perception (Z -4.7) and Santa Catarina with perception of sufficient physical, human and material resources (Z -4.9). Three of the eight studied metropolitan municipalities registered the highest unmet need.