Background: In French Guiana, health inequalities are evident across a wide range of conditions and among all age groups. The objective of this study was to quantify the proportion of the population that had foregone care in the past year, to identify predictive factors, and to compare the results with those from other French territories. Methods: A two-stage random sample of 2,015 individuals aged 15 to 75 years was surveyed by telephone. A descriptive analysis of variables related to forgoing care, health care utilization, screening, and vaccination was initially performed. Multivariate analysis was then used to identify variables associated with forgoing care for financial reasons, and forgoing care for time-related reasons was directly estimated using a Poisson model on weighted data. Variables with a p-value < 0.2 in the bivariate analysis were included in the full multivariate model. Results: In French Guiana, over the past 12 months, 30.9% of surveyed individuals forwent care of any type for financial reasons. Results of the multivariate analysis showed that gender, perceived financial situation, perceived health, and supplementary insurance status were independent predictors of forgoing care for financial reasons. Overall, 24% of the surveyed population reported having forgoing care for time-related reasons. The independent predictors for time-related forgoing were different from those for forgoing care due to financial reasons: a higher level of education and poor perceived health were independently associated with time-related forgoing; retired individuals and students were found to forgo care less frequently than employed individuals. Conclusions: Forgoing care due to financial reasons, a major focus of the 2016 health law, represented a public health problem in French Guiana. Failing to seek care due to lack of time was a significant reason for forgoing care, a situation exacerbated by the shortage of healthcare professionals but one that could be addressed through organizational solutions. There are avenues for improving health outcomes for the most vulnerable: promoting health, addressing risk factors, and enhancing the clarity and accessibility of the healthcare system. Recent reforms aimed at stabilizing health insurance may, however, have some adverse consequences for migrants.