Primary Health Care (PHC) is fundamental to achieving health equity, ensuring timely access to essential services, community participation, and addressing social determinants of health. In Panama, despite sustained economic growth and increased health expenditure in the last decade, significant disparities persist, especially among rural, indigenous, and low-income populations. A predominant allocation of resources to tertiary and quaternary care continues to undermine PHC capacity, affecting service accessibility, continuity, and quality.This study aims to analyze the socioeconomic barriers limiting equity in PHC in Panama, evaluating their impact on core equity indicators (availability, accessibility, acceptability, and quality) and examining territorial disparities in health resource distribution.A comprehensive review and synthesis were conducted using three key documents focused on health inequities, social determinants, and access barriers across urban, rural, and indigenous contexts.Findings reveal that structural, financial, geographical, and organizational barriers disproportionately affect vulnerable populations. Identified limitations include institutional fragmentation between the Ministry of Health and the Social Security Fund, unequal distribution of healthcare professionals, reduced primary care capacity, high indirect patient costs, inadequate infrastructure, and recurrent shortages of medical supplies. Additionally, social determinants such as multidimensional poverty, low educational attainment, and urban centralization exacerbate inequities, directly impacting all dimensions of equity.These barriers compromise not only access but also the timeliness, continuity, and quality of care. Evidence suggests that increased health expenditure alone is insufficient unless accompanied by effective redistribution of resources toward primary health care and targeted policies for historically underserved areas. Strengthening PHC infrastructure, integrating care networks, and addressing underlying social determinants are essential strategies to improve equity and effectiveness, particularly in rural and indigenous territories where historical exclusion correlates with poorer health outcomes.In conclusion, despite investments and economic progress, PHC in Panama remains challenged by persistent gaps in equity, coverage, and quality. Addressing these inequities requires comprehensive policies that combine resource reallocation, PHC strengthening, and interventions on social determinants, ensuring accessible, continuous, and equitable health care for all.