This study aims to determine the effect of organizational commitment, organizational culture and leadership style on managerial performance with public accountability as an intervening variable in Dompu District Hospital. The subjects in this study were employees in the financial, service, verification, program and administration departments. This study uses primary data by conducting a survey, which distributes instruments in the form of questionnaires to respondents. The sampling technique used in this study is the purposive sampling method, where the technique determines the sample based on the purpose, intentions, and certain considerations so that it can represent the real data. Respondents in this study were 50 respondents. The analytical method of this study uses multiple linear regression. Based on the analysis conducted, the results show that organizational commitment, organizational culture and leadership style have a positive effect on public accountability. Organizational commitment organizational culture, leadership style and public accountability have a positive effect on managerial performance. Then the next result is organizational commitment and organizational culture has a positive effect on managerial performance through public accountability while leadership style does not affect managerial performance through public accountability.