Long-acting reversible contraceptive usage is low globally, given its highly effective nature. There is scant literature on the use of intra-uterine device (IUD) across both rural and urban residencies. This study examined the usage of IUD and the expectations of married Chinese women on family planning (FP) services in rural and urban areas. A community-based study was conducted in Hubei Province, China, via cluster sampling method between 2014 and 2016. A total of 6356 married women (18-49years) present in rural and urban residencies were sampled. Multiple logistic regression was performed using IBM-SPSS (v22.0) to identify determinants of IUD usage at p ≤ 0.05. IUD usage was 53.7% in urban and 57.2% in rural areas. Most women hoped for a regular reproductive health examination to be provided. IUD usage among rural residents was negatively associated with age, educational level, parity and spouse contraceptive usage, but positively associated with knowledge of vasectomy as contraceptive, discussing contraceptive with spouse and men’s involvement in FP services. IUD usage among urban residents was negatively associated with age, having one child, spousal contraceptive usage and participation in FP services education, but positively associated with educational level, having no child, knowledge of vasectomy as contraceptive and discussion on contraception. There is a need to improve the dissemination of family planning methods and education to the clients and spouses in both rural and urban areas to meet universal healthcare coverage goals.