Primary health care (PHC) should be a preferential way to access healthcare. Access to PHC is fundamental in terms of preventive medicine and an important health equity indicator. In Portugal, PHC has been continuously strengthened with an ongoing reform initiated in 2006. Although migrants are recognized as a group that tend to underuse preventive healthcare services, knowledge about patterns, determinants and barriers to migrants’ access and use PHC is still scarce. Using data from the National Health Survey we compare migrants’ access and utilization of PHC in 2005 and 2014. For the same time period, we explore the existing policies regarding migrants’ access to healthcare services and, more specifically to PHC. Through document analysis, we describe the main barriers to migrants’ access to PHC. Based on the results, we discuss how policies on migration and health, the economic crisis and PHC reform can explain access to PHC by migrants in Portugal. Resulting recommendations will inform policies and strategies that will promote access to PHC by migrants and reinforce preventive and health promotion initiatives among this population.