SummaryObjectivesTo investigate patient satisfaction regarding healthcare services at a district hospital. The research question was: what is the level of patient satisfaction regarding service delivery?DesignAn observational cross-sectional descriptive study conducted in September 2019.SettingsA district hospital in Botswana serving a population of 90 000. Outpatients from the Eye clinic, Casualty and Outpatient Department, Sexual Reproductive Health clinic and Infectious Diseases Control Centre were selected for the studyParticipants240 stable outpatients over 17 years selected through consecutive sampling participated voluntarily after giving informed consent.Main outcome measuresThe level of satisfaction was measured using 19 questions on five-point Likert scales ranging from strongly disagree 1, disagree 2, unsure 3, agree 4 to strongly agree 5. A binary outcome was created into satisfied and unsatisfied using the mean score as the cut-off point. Age, gender, employment, education and departments were independent variables.Results65% (95% CI: 58–71%) were satisfied but unsatisfied with: doctor's politeness (66.9%; 95% CI: 60–73%), explaining (67.8%; 95% CI: 61–73%), privacy (65.6%; 95% CI: 59–72%), skills (67.4%; 95% CI: 61–73%), confidence (67.4% 95% CI: 61–73%), compassion (66.5%; 95% CI: 60–72%) and waiting time (49.2%; 95% CI: 42–57%). Department visited predicted satisfaction (p=0.002); those from the Eye clinic and Sexual Reproductive Health clinic were satisfied compared to others.ConclusionSatisfaction was generally high but lower regarding specified services and departments visited. There is a need for targeted interventions. Studies are needed to explore reasons for lower satisfaction in Casualty, Outpatient Department and Infectious Diseases Control Centre.FundingNone declared