The Puskesmas not only provides access to healthcare but is also expected to innovate according to local needs, especially in remote areas. However, limitations in human resources, facilities, and budgets often hinder the effectiveness of services. Therefore, the Puskesmas requires competent workforce to improve performance and service quality, with human resources being a key factor in the organization's success. This study aims to examine and analyze the influence of workload and service innovation on employee performance with work engagement as an intervening variable at the UPT Puskesmas Kecamatan Kuala, Langkat Regency. The research uses a quantitative approach. The population for this study consists of 129 employees of UPT Puskesmas Kecamatan Kuala, Langkat Regency, with the sampling technique used being saturated sampling, which is part of non-probability sampling, involving all 129 employees as the sample. The data analysis technique used in this study is descriptive statistical analysis and structural equation modeling (SEM). The results of this study show that Workload (X1) has a positive and significant effect on Employee Performance (Y), Service Innovation (X2) has a positive and significant effect on Employee Performance (Y), Work Engagement (Z) has a positive and significant effect on Employee Performance (Y), Workload (X1) has a positive and significant effect on Work Engagement (Z), Service Innovation (X2) has no effect on Work Engagement (Z), Workload (X1) has a positive and significant effect on Employee Performance (Y) through Work Engagement (Z), and Service Innovation (X2) has a positive and significant effect on Employee Performance (Y) through Work Engagement (Z) at UPT Puskesmas Kecamatan Kuala, Langkat Regency.