Background: Hospital is one of substantial institutions, because it is part of a system that brings health services to the community. Hospital is a contact point for patient who need health services, so patient experiences with health services in hospital can play an important role in its evaluation of service quality and might influence the regular use of services in the future. The purpose of this study is to analyze the effect of service quality on patient satisfaction and loyalty at Hidayah Boyolali Hospital. Subjects and methods: This research was a quantitative study with a cross sectional approach. The population is patient who receive health services at Hidayah Boyolali Hospital. The number of samples in this study were 100 which were obtained with purposive sampling method. Data collection was carried out through a survey using a questionnaire with a Likert scale. Data analysis was performed using SEM-PLS (Structural Equation Modeling-Partial Least Square). Results: Service quality had positive and significant effect on patient satisfaction (T statistic = 33,024 and P Value = 0,000). Service quality had positive and significant effect on patient loyalty (T statistic = 2.972 and P Value = 0.003). Patient satisfaction had positive and significant effect on patient loyalty (T statistic = 3.148 and P Value = 0.002). Service quality had indirect effect on patient loyalty through mediating patient satisfaction (T statistic = 3.114 and P Value = 0.002). Conclusion: Service quality had positive and significant effect on patient satisfaction and loyalty. Service quality had indirect effect on patient loyalty through mediating patient satisfaction.