Background: Elective surgery is a planned medical procedure requires optimal coordination from the pre-operativeto post-operativephases. As a national referral hospital, Adam Malik Hospital in Medan handles a high volume of elective procedures, making the evaluation of service quality essential. Objective: This study aimed to describe patient characteristics and assess service quality in the operating room of ahospital. Methods: A descriptive quantitative study with a cross-sectional approach was conducted, involving 580 patients undergoing elective surgery. Service quality was assessed using objective clinical indicators, including the punctuality of the anesthesiologist and surgeon, the time from patient entry into the operating room to anesthesia induction, the interval between anesthesia induction and surgical incision, and the postoperative pain score. Data were collected from medical records and analyzed using Statistical Package for the Social Sciences (SPSS). Results: Most patients were aged 18–40 years (48.8%), with a mean age of 40.5 ± 22.42 years. Females accounted for 53.8% of the samples, and the majority were classified as ASA III (44.7%). Pain was the most common surgical indication (45.9%), with orthopedic surgery was the most common procedure (24%). The average body mass index was 22.44 ± 4.38. General anesthesia was administered in 86.2% of cases. A mismatch between operator arrival and incision time occurred in 69.3% of cases. The average post-operative pain score was 3.47 ± 0.811. Conclusion: Overall, 70.3% of patients received good-quality service based on objective clinical indicators. However, improvements are still needed in surgical timing efficiency and interdisciplinary coordination. It is recommended to enhance surgical scheduling systems, implement regular team training, and optimize perioperative protocols to improve the quality and consistency of elective surgical care.