An audit of 954 family planning clinic attendees, who received counselling from 2006 to 2010, was conducted at the only federal government owned tertiary hospital in Ondo state, Nigeria. Of these, 637 (66.8%) accepted a family planning method: 47.6% chose injectables, 23.2% intrauterine device, 19.5% oral contraceptive pills, 4.4% barrier methods, 3.3% implants and 2% tubal ligation. Clients who had some primary education [OR: 2.79; (95% CI: 1.14–6.84; p < 0.05] had statistically significant higher odds of accepting any contraceptive method while those with elevated blood pressure at first visit [OR: 0.23; 95% CI: 0.12–0.45; p < 0.001] and those with previous episode(s) of induced abortion OR: 0.57; 95% CI: 0.43–0.76; p < 0.001] had statistically significant lower odds of using any method. Concerted efforts at increasing uptake is advocated to bridge the gap between client counselling and uptake.