To evaluate the mediating effect of utilization propensity (UP) on gender differences in healthcare utilization (HCU), a representative sample of the German general population (N = 2,510) was assessed with questionnaires. Gender differences in HCU, UP, and the mediating effect of UP were investigated using regression analyses. UP was significantly associated with HCU. The explanatory power of gender for UP, and of UP for HCU was prevailingly weak. UP had a mediating effect on gender differences in HCU, but the effect was very small. This is partly attributable to common problems in the prediction of behavior by attitudes and the operationalization of UP.