Critical External Institutional Pressures towards Effective Implementation of IFRS in the Tanzanian Private Hospital Sector Latifa Hamisi Mbelwa16 Deogratius Ng‘winula Mahangila17 Abstract This paper reports the findings of a study that investigated the critical external institutional pressures-related factors in emerging economies that influence the effective implementation of International Financial Reporting Standards in the private hospital sector. The study had employed an explanatory research design that entailed the collection of 72 questionnaires from ten major private hospitals in Tanzania. The data were then subjected to multiple linear regressions. The study established four critical external factors to influence the effective implementation of International Financial Reporting Standards. These factors are pressure from successful hospitals; pressure from lending and financial institutions; International Financial Reporting Standards requirements; and the National Board of Accountants and Auditors’ pronouncements. In the meantime, pressure from donors and the Tanzania Revenue Authority seemed to have moderate and weak influences, respectively. In a broad sense, the findings revealed the role of New Institutional Sociology in advocating for the influence of coercive pressures associated with financial resources dependence from lending institution; and normative institutional pressures associated with the role of local and international accounting boards in issuing pronouncements. However, the strong influence comes from memetic pressures associated with the modelling of successful organisations practices through employees transfer and turnover in such competitive and private natural environment, which result in the shaping of the private hospital sector towards effective implementation of International Financial Reporting Standards. On the whole, the paper highlights critical external institutional pressures for International Financial Reporting Standards effective implementation in an emerging economy using the case of Tanzania in which the private hospital sector is backing the public hospital sector. Keywords: International Financial Reporting Standards, Institutional Pressures, Private Hospital Sector and New Institutional Sociology