BACKGROUND: Patient’s satisfaction means the fulfillment of patient’s wishes, expectations or needs with quality of health care they receive. Satisfaction during a health care encounter is related to the relationship between the patients’ expectations and experiences. Measurement of patient satisfaction plays an important role in pushing health care providers towards being accountable to their patients, hence helps medical personnel to improve the services in order to meet client needs. This will encourage client to continue to seek medical services when they need. OBJECTIVES: To determine the level of patient’s satisfaction with health services among patients attending at surgical outpatient department (OPD) at Kilimanjaro Christian medical Centre (KCMC). METHODS; A descriptive cross section study was conducted at KCMC surgical OPD clinic. Where, 112 participants were interviewed by using SERVQUAL Questionnaire. Data analysis was done by SPSS version 20. RESULTS: The overall gap on health service provision at KCMC surgical OPD was -42.09 (±16.45) signifying overall dissatisfaction among patients in health service provision. Negative gap existed between expectations and perceptions in all five satisfaction domain showing that patients were not satisfied with the all five domains. Reliability had the highest perceptionexpectation mean gap score (-16.06) indicating that the level of satisfaction was the lowest on this domain .Smallest mean gap score was recorded on tangibles (-3.17) indicating that the level of satisfaction was the highest in tangibles. Most of the socio-demographic characteristics of patients involved in the study were not statistically significant except number of visits .Where by those who visited KCMC surgical OPD for the first time were less likely to be satisfied with health services compared to repeated visit mean gap was (-10.99) and p value was 0.005. CONCLUSION: In general participants were not satisfied with health services they receive at KCMC surgical OPD. There were negative gap in all domains and overall expectations and perceptions .This indicate that services need to be improved at KCMC surgical OPD in order to meet referral hospital standards and patients expectations in all SERVQUAL domains. It is recommended that KCMC surgical OPD have to improve quality of their services to met expectations of the patients and have a physical structure that better fits the patients’ expectations as indicated by the determinants of patient satisfaction in this study.