Primary healthcare as a decentralized medical service at the community area in Nigeria is bedeviled with challenges. In other words, this study takes a critical look at the challenges militating against primary health care delivery at the local levels in Nigeria regarding Enugu East local government of Enugu state. The study examines the efforts and challenges of Enugu East local government in improving the health care service in Enugu East rural communities. About the methodology of this study, it adopted a survey design with reference to primary source (structured questionnaire) as an instrument of data collection, the quantitative liket scale of data analysis and Easton’s political system framework for empirical analysis. This study further revealed that primary health care delivery is fraught with challenges (such as inadequate funding, drugs, quality service) which stem from the abysmal failures of Enugu East local government. This work, therefore, recommends measures such as improved budgetary allocation, strengthening the supply chain of drugs, enhanced clinical service as conditions imperative for improved health care service in Enugu East rural communities.