BACKGROUND: Patients/ health care seekers usually have expectations of their own as to what the quality of health care that they are going to receive at a health care centre is/ should be, which more often than not is what determines whether or not they are going to be satisfied. This study aimed at determining the level of satisfaction of patients with the quality of health care at the KCMC Obstetrics and Gynaecology Out-patient Clinic. OBJECTIVES: To determine patients’ level of satisfaction with health services at the Obstetrics and Gynaecology out-patient department (OPD) clinic of the Kilimanjaro Christian Medical Centre (KCMC), Tanzania. METHODOLOGY: A cross sectional study was conducted at the KCMC Obstetrics and Gynaecology Out-patient department clinic. Participants were selected using systematic sampling technique, and data was collected by entry and exit interviews using structured questionnaires (SERVQUAL questionnaires). Data collected was analyzed using the Statistical Package for Social Sciences (SPSS) program and is presented herein in percentages using charts and tables. RESULTS 57 respondents were interviewed in the study. The mean overall mean satisfaction gap for The Obstetrics and Gynaecology OPD of KCMC Hospital was -16.6 (±20.5). The overall mean gap between perception and expectation ranged between -77 and 33. The overall level of satisfaction was 21.1%. As for the association between patients’ level of satisfaction with their sociodemographic characteristics, only Occupation was found to be statistically significant (Mean gap 11.2, 95% CI (-1.5, 24), p-value = 0.011). The Mean gap scores for all domains were -2.3 for Reliability, -6.5 for Responsiveness, -1.2 for Tangibles, -3.3 for Assurance and -3.2 for Empathy. CONCLUSION Respondents generally expressed dissatisfaction with health care services (the level of satisfaction is 21.1%). The negative mean gap score and negative mean scores for domains also xiii concurred with the overall level of dissatisfaction by respondents as their expectations surpassed their perception of the quality of service. RECOMMENDATIONS The hospital administration should work on improving the quality of care given at KCMC Obstetrics and Gynaecology OPD. Health care workers should also do their tasks as required, and act with empathy and respect towards patients.