Customer satisfaction is a significant element for a service user to create and retain customers successfully. This can be made if good service quality, health facilities, and brand image support a health service. This study aimed to determine and analyze how much influence quality, facilities, and brand image have on patient satisfaction—cross-sectional quantitative research approach, conducted at Royal Prima Medan Hospital, May 2023. The population of all outpatient and inpatient patients, determination of the number of samples Structural Equation Modeling (SEM), determined 100 models, nonprobability method -survive sampling. Data was tested for validity and reliability. Multiple linear regression data analysis, coefficient of determination (R2), F test (simultaneous testing), t-test (partial testing) at α = 0.05. The results of the service quality variable, t-count (6.772) > t-table (1.66) probability value (0.009) < 0.05, service facility variable (t-count value > t-table (6.772) > t-table (1.66) and probability value (0.009) < 0.05, brand image variable t-count > t-table (6.921) > t-table (1.66) and probability value (0.002) < 0.05, so that the three variables have a significant relationship with patient satisfaction. The calculated F test obtained an F value of 88.121 with a probability of 0.012 ≤ 0.05. In conclusion, the results of partial and simultaneous tests, service quality variables, service facilities, and brand image have a positive and significant effect on patient satisfaction at Royal Prima Medan Hospital, with an Adjusted R square value of 0.845, meaning that 84.5% of the variation in the dependent variable on patient satisfaction at Royal Prima Hospital can be explained by variations in the independent variables of service quality, brand image, and facilities, the remaining 15.5% (100%-84.5%) is defined by other variables not examined in this study, such as price, distance, and others.