OBJECTIVE To study the reasons for refusing IUCD services in spite of the need for temporary contraception and to counsel the client into accepting it for long and short term health benefits. BACKGROUND India is a vast country, a sub-continent and majority of the population is young and is in the reproductive age group. It comprises of yet to be married group, married but want to postpone pregnancy group, wants to space next pregnancy group. Tubectomy operation, an excellent permanent birth control measure is not valid in the above groups. Their specific need is an effective, temporary and reversible contraception. With different failure rates and specific contraindications, many temporary methods do not suit them. IUCD is one temporary contraception, which fulfils maximum criteria needed by them. It is not only highly effective and temporary, but can be used as a long-term contraception too. In spite of its advantages, the acceptance is too low and various factors influence the same. Lack of awareness and fear of unknown is one area where counselling by one-to-one method is fruitful. Mass media usage and wide publicity may arouse the element of interest in the needy women leading to curiosity and a desire to know more about it by them. Counselling and service provision may bring in the necessary change in the attitudes of the clients. PLACE AND DURATION OF STUDY A study is conducted at Government Maternity Hospital, Sultan Bazaar, a teaching hospital of Osmania Medical College, Hyderabad, from January 2006 to December 2011. A total of 3080 clients who are eligible for IUCD are studied and counselled for IUCD. Clients who accepted and got IUCD inserted were followed up to 2 years. RESULTS Of the total of 3080 patients, only 10% agreed to IUCD insertions and about 85% refused despite counselling. Illiterate women were 68%, but surprisingly 1% of the study group of professionals including doctors refused too. More than 90% are aged 25 yrs. or less constituting the potential group needing spacing method most. Rural based women are 64% and denote a large unmet need. In spite of city based, 1/3rd women do not seek contraception services. There is nil knowledge regarding contraception in 67% of clients and majority come from low socioeconomic background needing urgent conduct of awareness programmes. Resistance to acceptance seen in 81%, the reason being fear and misconceptions. CONCLUSION Lack of awareness and wrong notions are the main reasons for refusing an excellent non-hormonal, reversible and effective contraception. Calls for an urgent attention to counselling services and wide governmental publicity.