OBJECTIVES Older people are vulnerable to medicine-related adverse effects. In response to these concerns, prescribing indicators have been developed addressing: Potentially Inappropriate Medicines (PIMs), medicines with unfavourable risk-benefit ratios and Potential Prescribing Omissions (PPOs), omission of indicated medicines with a clear benefit. Little is known about the impact of PIMs and PPOs on healthcare utilization. This study aims to determine the association between PIMs and PPOs and healthcare utilization. METHODS This is a retrospective cohort study of 2,051 community-dwelling participants in The Irish Longitudinal Study on Ageing (TILDA) aged ≥65 years with linked medication dispensing history from a national pharmacy claims database. PIM and PPO exposure in the 12 months prior to participants’ TILDA interviews was determined using validated prescribing indicators: Screening Tool for Older Persons’ Prescriptions (STOPP), the Screening Tool to Alert doctors to Right Treatment (START), Beers’ criteria and Assessing Care of Vulnerable Elders (ACOVE) indicators. Outcome measures used were self-reported number of hospital visits (emergency department or inpatient admissions) and general practitioner (GP) visits in the previous year. Poisson regression models were used to determine the associations between PIMs and PPOs and these outcomes, adjusting for age, sex, education, number of medications, chronic conditions, and health insurance status.  RESULTS Overall PIM prevalence was 19.8-52.7% and PPO prevalence was 43.6-44.8% depending on the screening tool applied. Independent of screening tool used, PIMs and PPOs were significantly associated with hospital visits. For example, the adjusted Incident Rate Ratio (IRR) for each additional STOPP PIM was 1.24 (95%CI=1.15-1.35). With the exception of START PPOs, PIM and PPO exposure were also significantly associated with GP visits (adjusted IRR=1.10 (95%CI=1.06-1.15) for each additional Beers’ PIM for example). CONCLUSIONS PIM/PPO exposure is independently associated with increased healthcare utilization, supporting application of PIM/PPO indicators as robust measures of healthcare quality and patient safety in relation to prescribed medications.