Introduction: The level of patients’ satisfaction is important for improving the quality of care provided to patients, because it reflects the gap between the expected service and the experience of the service, from the patients’ point of view. It can be used as a foundation of encouraging health care providers to become more responsible to their patients. Objective: To determine patients’ level of satisfaction with health services at the Orthopedics out-patient department (OPD) clinic of the Kilimanjaro Christian Medical Centre (KCMC), Tanzania. Methodology: A cross sectional study was conducted at the KCMC Orthopedics Out-patient department clinic. 140 patients were selected using systematic sampling technique during the study period 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) version 22. Results: The overall patients’ level of satisfaction at Orthopedic OPD of KCMC hospital was low (dissatisfaction). With the overall gap of -16.536 (±22.26). Of the five service domains namely Tangibles, Reliability, Responsiveness, Assurance and Empathy; differences existed between expectations and perceptions of the quality of services provided showing that patients were not satisfied with the health services delivered at KCMC orthopedics OPD. Responsiveness had the highest perception-expectation mean gap score (-5.45) indicating that the level of satisfaction was the lowest on this domain, followed by Reliability (-3.207). Smallest mean gap score was demonstrated by assurance (-2.007) indicating that the level of satisfaction was the highest in assurance. Conclusion: In general the study showed participants were not satisfied with health services they receive at KCMC orthopedics OPD. There was negative gap in all domains and overall expectations and perceptions. So to achieve the patients’ expectations, the quality of health services needs to be improved through improving all the five SERVQUAL domains at the KCMC orthopedic OPD.