Aim: To determine the Prevalence of Presbyopia and Presbyopic spectacle utilization rate in Otukpo Local Government Area, Benue State, Nigeria, in order to provide a template for effective delivery of optical and refractive services. Method: A population-based quantitative and qualitative cross-sectional survey was conducted in adults aged 40years and above in Otukpo local government area between 25th March and 15th April 2014. A multi-stage cluster random sampling proportionate to size was used to select 15 clusters of 40persons per cluster. Uncorrected or undercorrected presbyopia was near vision worse than N8 at 40cm with or without near vision correction. Those who were using or had near vision spectacles were identified. Information on barriers to use of presbyopic spectacles, and the utilizations of presbyopic services were collected using structured questionaire. Unmet and met presbyopic need and spectacle utilization rate were calculated. Results: 566 subjects were enumerated, 554 subjects were fully examined and interviewed with a response rate of 97.8%. The mean age of participants was 54.3years (95%CI: 53.4-55.2). The prevalence of presbyopia was 56.1% (95% CI: 44.3-57.9).The prevalence of presbyopia was significantly higher in females (p=0.00) and is not associated with level of education. The met presbyopic need was 7.8% and the unmet need was 48.4%. The presbyopic spectacle utilization rate or the presbyopic spectacle correction coverage (PSCC) was 13.8%. Higher spectacle utilization was seen amongst the male participants, those with at least secondary school education and those who were civil servants. The commonest barriers to use of presbyopic 1 spectacles were lack of money (22.1%) and not knowing where to access presbyopic services (17.3%). The female participants experienced more barriers to use of near vision correction (p value=0.003).Analysis of degree of presbyopia showed that females had more severe presbyopia than males (1.7D versus 1.4D, p value=0.000). Presbyopia affects a host of near vision tasks, and impaired near visual function was more with other tasks compared to reading and writing. Conclusion: The study has demonstrated that over half of the adult population in Otukpo local government area is presbyopic. It also provides helpful findings to assist with the development of appropriate presbyopic services in the local government, with emphasis on consideration for specific needs that women have for near vision.