Introduction: Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. Yet catastrophic expenditure is not rare. We investigated the extent of catastrophic health expenditure as a first step to developing appropriate policy responses..

Methods: Data from household surveys in Iran were used to explore, variables associated with catastrophic health expenditure analyzed by regression. We defined expenditure as being catastrophic if a household’s financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met.

Results: In 2007, 2.5% households were faced with catastrophic payments and FFCI is 0.833 shows the lack of an efficient and comprehensive health insurance .Among Iranian, these groups are more susceptible to catastrophic health expenditures: rural families, the families with children below 12 years and old above 60 year, the families who have no insurance.

Conclusion: People, could be protected from catastrophic health expenditures by reducing a health system’s reliance on out-of-pocket payments and providing more financial risk protection. More availability of health services could raise the proportion of households facing catastrophic expenditure risk protection policies would be especially needed. National health systems could be financed so that protect households from catastrophic spending and provide access to needed services.