The increasing number of hospitals and the increasing demands of the community for quality and affordable health facilities, make the hospital must always try to maintain and meet the demands of society amid current competition. So it must be known what can affect patient satisfaction and loyalty. This study aims to determine whether there is an influence between hospital image on patient satisfaction, hospital image on patient loyalty, and satisfaction with patient loyalty in outpatient PKU Muhammadiyah Gamping Yogyakarta Hospital. The population in this study were outpatients at PKU Muhammadiyah Gamping Hospital. The sample used was 100 patients and the method used was quantitative descriptive. Data collection was done by distributing questionnaires to respondents. Variables in this study were X1 hospital image. X2 Patient satisfaction, and Y patient loyalty. The data will be analyzed using SEM analysis tools through AMOS. From the analysis results have met the Goodness of Fit criteria, namely CMIN / DF, RMSEA, TLI, CFI. There are 4 indicators of Goodness of Fit that are included in the recommendation value or in a good category, it can be concluded that the model is suitable for use. Processing results using AMOS show that hospital image has an effect on satisfaction, The image has an influence on loyalty, Satisfaction has an influence on loyalty. The results of this study are that there is a positive influence between hospital image, patient satisfaction, and patient loyalty. The results show that all three hypotheses are acceptable. Keywords: hospital image, patient satisfaction, patient loyalty.