BackgroundAsylum seekers and refugees often experience poor health in host countries. The United Nations High Commissioner for Refugees requires hosts to ensure these sanctuary seekers have access to basic health care.AimTo identify barriers and facilitators that affect access to health care by asylum seekers and refugees in Wales.Design & settingParticipatory research approach using qualitative focus groups across Wales, which hosts 10,000 refugees..MethodEight focus groups with asylum seekers, refugees and support workers and volunteers.(n=57)ResultsSpecialist NHS-funded services and grant-aided Non-Governmental Organisations (NGOs) facilitate access to health care, including primary care. Most asylum seekers and refugees understand the role of general practice in providing and coordinating care but are unaware of services out of hours. Reported barriers include: language difficulties, health literacy, unrecognised needs, and the cost of travel to appointments. Participants recognise the importance of mental health, but were disappointed by the state of mental health care. Some fear seeking support for mental health from their GP, but few are aware they have the right to move practice if they were unhappy. Written information about health care is not as accessible to refugees as to asylum seekers. While some participants read such material before consulting, others struggle to access information when in need. Few participants are aware of health prevention services. Even when they know about services like smoking cessation, these services’ difficulty in accommodating asylum seekers and refugees is a barrier.ConclusionMain barriers are: availability of interpreters; knowledge about entitlements; and access to specialist services.