This paper highlights financial considerations in establishing and running student-led clinics, in two differing national contexts of Australia and New Zealand. Student-led services, where students in healthcare programmes are engaged in delivery of care under the supervision of health service staff and/or teaching faculty, are increasing in number globally and can offer both valuable clinical learning opportunities and cost-effective and complementary primary healthcare. However, achieving financial viability and sustainability remains a common challenge. Clinics often find themselves caught in a gap between government funding streams of health funding intended to fund provision of health services versus education funding allocated for teaching, learning or research purposes. We consider the costs associated with establishing student-led clinics and explore possible options for longer-term financial sustainability.