While India has made significant strides in health indices under the initiative of universal healthcare access, the unmet medical need is still substantial. As per the 75th National Sample Survey round, around 12% of ailed people were not accessing healthcare services from facilities despite reported illness. To ensure universal access to healthcare access, the identification of factors impedes healthcare access is crucial for appropriate policy intervention. The present paper attempts to fill this gap through analysing the trend and correlates of unmet need for healthcare. Various rounds of National Sample Survey data are used for analysis. The findings suggest despite the rhetoric of universalisation of healthcare, a substantial share of ailed persons could not access care from health facilities. Although the unmet need declined over time, the socioeconomic differentials in unmet needs are widening and acceptability related unmet need was more than the health system barriers. The findings from the regression analysis show that ailed persons belong to low economic class and from underdeveloped regions have higher unmet need. Community level interventions to create health awareness prioritising the marginalised and younger age group is important for reducing the acceptability related barriers. A multisectoral policy approach with strategies to address geographical heterogeneity is required for reducing overall unmet medical needs.