This study aims to determine and analyze the influence of strategic leadership and performance appraisal on job satisfaction and its implications for employee performance at Prof. Dr. H. M. Anwar Makkatutu Bantaeng Regional General Hospital. The quantitative research method used was descriptive and verification analysis to examine the influence of variables on 88 respondents. The results of the study showed that there was a significant influence of the variable of strategic leadership influence on employee performance, obtaining a coefficient value of 26.7% with a calculated t value of 9,275, performance assessment on job satisfaction 41.2% with a calculated t value of 11,518, job satisfaction on performance 61.9% with a calculated t value of 11,817, strategic leadership on employee performance 4% with a calculated t value of 2,170, performance assessment on employee performance 8% with a calculated t value of 2,994, the simultaneous influence of strategic leadership and performance assessment on job satisfaction with a calculated f value of 11,964, the indirect influence of strategic leadership on employee performance through job satisfaction 40.6% with a Sobel test value of 4,183, performance assessment on employee performance through job satisfaction 50.5% with a Sobel test value of 3,404 with all p values 0.005. This means that all hypotheses are accepted. The research concludes that hypotheses 1-8 have direct, simultaneous, and indirect effects, capable of mediating between variables.