The phenomenon of health seeking behavior in the developing world has always been of interest to both researchers and policy makers. Over the years many academic and policy research have been done on this subject, however, these works have often failed to capture the health seeking behavior from a pluralistic health system perspective. Most works have concentrated on one health system at the neglect of the other when examining the health seeking behavior in the developing world. In the ones that have examined this phenomenon from both modern biomedicine and indigenous traditional medicine, the concept of spirituality and health has been totally ignored or given little attention. In light of this, the study sought to examine health seeking behavior in the Asikuma-Odoben-Brakwa district of Ghana from health pluralistic perspective giving attention to the issue of spirituality and health. The chosen study area is a predominantly rural district with few biomedical facilities thus helping to view the phenomenon from the angle of the rural, poor and vulnerable – a group that have been identified as most affected in the health care system of the developing world. A conceptual model of factors that determine health seeking behavior for both biomedicine and traditional medicine was developed based on a modified models of Aday and Andersen (1974) and Buor (2004) behavioral models of health care utilization. To appreciate the breadth and depth of this phenomenon, the study employed both quantitative and qualitative methods of research in soliciting for primary data from the field. The findings of this study revealed that despite various policies made to make biomedicine accessible to Ghanaians such as introduction of the National Health Insurance Scheme and Community Health Posts, majority of people in the study district still use self-treatment as their first choice in addressing their health needs. Although a vast majority would prefer using biomedicine to meet their health care needs, barriers such as finance and time prevent them from doing so. The preference for biomedicine was high compared to traditional medicine or self-treatment among respondents irrespective of their geographic location, gender, educational and economic background. Financial barrier was also seen as a challenge to access to traditional medicine, especially with the monetization and formal institutionalization of the practice. The study also revealed that the media plays an important role in the decisions and drugs people use for self-treatment; also family and social relations play a key role in determining the choice of treatment for terminal and sever ailments. The study also revealed a strong attachment among respondents and informant for spirituality and health irrespective of their socio-demographic background. Determining whether an ailment is spiritually caused comes through a complex process of social identification either by the patient or by a recognized healer. Patient often associated ailment with spiritual causation after failure of other remedies in healing and In the situation where the ailment comes after social dispute. Often, the choice of which type of healer used in addressing such ailment depends on factors such as one s religious orientation. The practice of buying substances from drug peddlers believed to have special powers to solve and heal spiritual infirmity is also another health seeking behavior exhibited by informants and respondents in meeting their spiritual health needs.