Objectives Previous studies have shown the beneficial impacts of arts participation and cultural engagement on health outcomes. However, this engagement is socially patterned and is also possibly influenced by geographical factors. Study design The aim of this study was to examine the association between geographical factors (spatial setting and neighbourhood characteristics) and arts and cultural engagement amongst adults in the UK. Methods Data analysed were from Understanding Society Wave 2 (2010/12) with a total sample size of 26,215. Logistic and ordinal regression was used to identify geographical predictors for the patterns of the engagement. Results Our results show that there are geographical differences in participation independent of individual demographic and socio-economic backgrounds. In particular, there was more evidence for differences in the participation based on neighbourhood characteristics (e.g. level of area deprivation). We also found some interactions between individual and geographical factors for cultural engagement but not for arts participation. Conclusions This study reveals a geographical and individual socio-economic gradient in arts and cultural engagement. Given the health benefits of arts engagement, improving access to arts and cultural programmes geographically may potentially help to reduce health inequalities.