Aim Increasing service use under the long‐term care insurance (LTCI) system in Japan requires a comprehensive understanding of how the services are actually used. This study aimed to identify patterns of LTCI service use and to examine the characteristics of the patterns. Methods We analyzed data from a population of 4,339 older adults living in the community who were certified as “Needing Care” and were using at least one LTCI service in a suburban municipality of Japan. We identified six patterns of service use using cluster analysis based on the amount of fees for LTCI services and compared characteristics among the clusters. Results The clusters were: 1) light use of care services (n = 1,852); 2) day care‐centered (n = 1,071); 3) day care with rehabilitation‐centered (n = 616); 4) home help‐centered (n = 365); 5) short‐stay respite service‐centered (n = 246); and 6) compound uses of visiting services (n = 189). “Home help‐centered” and “short‐stay respite service‐centered” clusters used a large number of fees, whereas “compound uses of visiting services” clusters did not despite their severe conditions. The “day care‐centered (with rehabilitation)” classification included few people who needed medical procedures, likely due to the lack of medical facilities in those agencies. Conclusions The results show the impact of social and medical factors on LTCI service use, suggesting possible difficulties in the socialization of care. The clusters could be used as typical service use patterns, providing a framework for further studies, such as those evaluating the services’ effects. Geriatr Gerontol Int 2017; 17: 753‐759.