Background: The October 2023 war in Gaza has impacted the health system and increased the economic burden in Gaza. Aim: To assess the effects of the war in Gaza on health care costs and access to services. Methods: Between February and May 2024, this cross-sectional survey collected data from 658 individuals in Gaza on health care costs, obstacles to access and the effectiveness of health care services. Data analysis was conducted using SPSS version 25 and the relationships between the variables were determined using the chi-square test. Associations were considered statistically significant at P < 0.05. Results: Seventy percent of the study participants reported increased health care costs because of the war; 40% relied on personal savings and 25% on aid to cover their medical expenses. The main barriers to accessing medications were shortages (70%), high prices (60%) and poor distribution (50%). Higher income levels were correlated with reduced barriers to access (P < 0.01) and higher education levels were associated with greater satisfaction with services (P = 0.02). Conclusion: The war has disrupted the healthcare system in Gaza, seriously affecting the cost, access and quality of services. In addition to a permanent ceasefire, targeted actions are needed to lessen the economic burden on the population and improve service delivery.