Abstract Background The validity of self-reported mammography uptake is often questioned. We assessed the related selection and reporting biases among women aged 50–69 years in the Belgian Health Interview Survey (BHIS) using reimbursement data for mammography stemming from the Belgian Compulsory Health Insurance organizations (BCHI). Methods Individual BHIS 2013 data (n = 1040) were linked to BCHI data 2010–13 (BHIS–BCHI sample). Being reimbursed for mammography within the last 2-years was used as the gold standard. Selection bias was assessed by comparing BHIS estimates reimbursement rates in BHIS–BCHI with similar estimates from the Echantillon Permanent/Permanente Steekproef (EPS), a random sample of BCHI data, while reporting bias was investigated by comparing self-reported versus reimbursement information in the BHIS–BCHI. Reporting bias was further explored through measures of agreement and logistic regression. Results Mammography uptake rates based on self-reported information and reimbursement from the BHIS–BCHI were 75.5% and 69.8%, respectively. In the EPS, it was 64.1%. The validity is significantly affected by both selection bias