Alternative medicine (AM) has been widely practiced to manage health in many parts of the world for long. Pattern of use of AM differs by geographical locations and culture. Previous study findings suggest clear urban-rural divide on the frequency and pattern of use of AM This study was conducted to focus on this area for which little evidence exists within Bangladeshi context. Total of 230 women (115 from both rural and urban areas) of ?18 years of age were enrolled to collect information on frequency and pattern of use of AM in Bangladesh using structured questionnaire. The information was compared between the rural and urban areas to infer statistically significant differences. Proportion of participants using AM was greater among rural compared to urban women (67% vs 42%; p<0,004 The most commonly used modality of AM by urban was Homeopathy as opposed to Kaviraji and spiritual healing by rural users (75% vs 63% and 42% respectively; p<0.05). Relatively more among the urban were past users as opposed to greater proportion among rural respondents being current users of AM Simultaneous usage of both alternative and conventional method were more common among urban women. Most of urban had AM on daily basis in contrast to majority among rural users using it only once in a while. The most frequently treated conditions by AM were stiff or painful joints and arthritis among both groups and there were no significant statistical differences in this regard. Rural women used AM more often compared to women in urban setting. Homeopathy was the most commonly used modality of Al among urban in contrast to Kaviraji or spiritual healing among rural women. There were statistically significant differences for certain pattern of use of AM between women in urban and rural areas. Issues related to availability of conventional health care facilities, health care behavior and socio-demographic factors may play crucial role for these differences. Study with greater number of samples along with qualitative research methods to better characterize AM usage in both rural and urban settings are recommended.