Objectives The aim of this study was to explore the healthcare policymakers’ perspective about medical overuse in Iran.

Method Face-to-face interviews were conducted with a range of healthcare professionals involved in the policymaking process in the Iranian healthcare system. Interviews were digitally recorded, transcribed verbatim, and analyzed by two researchers using a qualitative content analysis method.

Results Forty in-depth semi-structured interviews were conducted. 10 themes were identified and cluster into three groups: 1) How to define; 2) How to detect; and 3) How to prevent medical overuse.

Conclusions This study introduced a conceptual map towards developing an approach to developing strategies for preventing medical overuse in the Iranian healthcare system. An evidence-based definition of medical overuse is the first step to choose preventive strategies. Then we needed to detect the areas that overuse happened and finally by identifying drivers we can implement the best preventive strategies.