The purpose of this study is to examine the impact of hospital image and quality of service on Discharge Against Medical Advice (DAMA) via patient satisfaction at Majene District Hospital. This research was performed in the hospital room of the Majene District Hospital from July to August 2020. The type of analysis used is quantitative research to explain the dependent variable's effect on the independent variable and the mediating variable. This study population was all 102 patients with DAMA at Majene Hospital, as the population was deemed limited and the whole population was sampled. The test results of the coefficient of determination of the path analysis of substructure 1 resulted in a modified R square value of 0.235. In this case, it is argued that patient satisfaction is affected by the hospital picture and quality of service by 23.5 percent. In comparison, the remaining 76.5 percent is influenced by other variables not analysed in this review. The outcome of the measurement of standardized beta coefficients, the effect of the hospital picture (X1) on patient satisfaction (Y1) is 0.228, and the service quality (X2) on patient satisfaction (Y1) is 0.325.