Background <p>Rural primary healthcare centres—particularly Sub-Centres (SCs)—in India play a critical role in ensuring equitable access; however, gaps persist in infrastructure, service delivery, and community engagement.</p> Aim <p>The study aimed to explore the lived experiences of trust and accessibility related to Sub-Centres (SCs) in rural West Bengal, focusing on accessibility, infrastructure, gender dynamics, and institutional trust as key determinants of healthcare engagement.</p> Methods <p>Qualitative, exploratory design was adopted, involving twenty-four participants, four Accredited Social Health Activists (ASHAs), and two Auxiliary Nurse Midwives (ANMs) from two Sub-Centres in the Sovanagar Gram Panchayat area of Malda District of West Bengal. Data were collected through semi-structured interviews and focus group discussions and analysed thematically.</p> Findings <p>Five major thematic domains emerged, (i) Knowledge and Experiences about the Health Centre; (ii) Practice and Accessibility; (iii) Challenges in Service Delivery; (iv) Gender and Power Dynamics; (v) Role in Community Health. While participants valued SCs for affordable and accessible care, persistent constraints such as inadequate infrastructure, irregular doctor availability, limited medicine supplies, and gendered barriers undermined service quality. Women were primary users, yet household hierarchies restricted decision-making autonomy. Despite shortcomings, SCs fostered trust, awareness, and preventive health behaviour through the active mediation of ASHA workers.</p> Conclusion <p>The findings highlight SCs as socially embedded institutions that extend beyond biomedical functions to serve as public spaces promoting collective well-being. Strengthening SCs requires addressing infrastructural deficits, ensuring consistent medical staffing, empowering ASHA workers, and embedding gender-sensitive and participatory approaches into rural health governance.</p>