Aim: The present study reports treatment utilization rates of pathological gamblers. Method: The population-based telephone survey is based on a random sample of 15 023 individuals. In addition, 303 gamblers recruited in 39 slot machine halls were interviewed. Gambling behavior and gambling problems were assessed in a computer assisted telephone interview. Among both samples together, 232 pathological gamblers were identified. Of them, 105 individuals received a clinical personal interview. Results: Among the pathological gamblers, 20 % reported contact to a treatment facility. More intensive help-seeking was reported by 10.5 %, with the main focus on addiction counseling services (5.7 %), self-help groups (4.8 %), and psychotherapy (3.8 %). Treatment utilization was associated with severity of gambling problems (p = .022). Moreover, data showed a significant correlation between certain DSM-IV criteria and treatment seeking. Conclusions: Results indicate that pathological gamblers are underserved. Treatment does not seem to reach those individuals who need it.