Abstrak Pelayanan rujukan kesehatan dilaksanakan berdasarkan kompetensi fasilitas kesehatan, namun masih ada kasus rujukaan penyakit non spesialistik ke fasilitas kesehatan tingkat lanjut pada Puskesmas di Kabupaten Polewali Mandar. Penelitian ini bertujuan untuk menganalisis rujukan penyakit non spesialistik ke fasilitas kesehatan tingkat lanjut pada Puskesmas di Kabupaten Polewali Mandar. Penelitian ini menggunakan pendekatan kualitatif dengan jumlah 11 informan. Validitas data dengan metode triangulasi sumber. Hasil penelitian menunjukkan faktor pemahaman Dokter tentang gatekeeper sesuai standar kompetensinya, faktor standar operasional prosedur rujukan tersedia di semua Puskesmas, faktor ketersediaan tenaga kesehatan sudah cukup dab sesuai latar belakang pendidikan profesi, sarana dan prasarana yang belum lengkap, faktor ketersediaan obat di Puskesmas yang masih kurang, dan faktor permintaan pasien untuk dirujuk yang masih ada namun Dokter tidak memberikan rujukan. Kesimpulan dari penelitian bahwa faktor pemahaman Dokter tentang gatekeeper, standar operasional prosedur sebagai pedoman rujukan, ketersediaan tenaga kesehatan Puskesmas, permintaan pasien untuk dirujuk tanpa indikasi rujukan, bukan penyebab rujukan penyakit non spesialistik ke fasilitas kesehatan tingkat lanjut. Sedangkan faktor ketersediaan sarana dan prasarana di Puskesmas, dan ketersediaan obat di Puskesmas menjadi faktor penyebab rujukan penyakit non spesialistik ke fasilitas kesehatan tingkat lanjut dari Puskesmas di Kabupaten Polewali Mandar. Sehingga disarankan bagi pihak Puskesmas untuk memberikan sosialisasi mengenai sistem rujukan berjenjang, dan disarankan pemerintah dan Puskesmas bersinergis untuk melengkapi sarana dan prasarana serta obat di Puskesmas. Abstract Health services are carried out based on the competency of health facilities, however there are still cases of referral of non-specialist diseases to advanced health facilities at the Community Health Center in Polewali Mandar Regency. This study aims to analyze referrals for non-specialist diseases to advanced health facilities at the Community Health Center in Polewali Mandar Regency. This research used a qualitative approach with 11 informants. Data validity using source triangulation method. The results of the research show that doctors' understanding of gatekeepers is in accordance with their competency standards, standard reference operational procedures are available in all health centers, the availability of health workers is sufficient and according to their professional educational background, facilities and infrastructure are incomplete, and the availability of medicines in health centers is still lacking. , and the patient's request for referral which still exists but the doctor does not provide a reference. The conclusion from the research is that the doctor's understanding of gatekeepers, standard operational procedures as referral guidelines, availability of health workers at the Community Health Center, patient requests for referral without indication of reference, are not the cause of disease referral. non-specialist to further level health facilities. Meanwhile, the availability of facilities and infrastructure at the Puskesmas and the availability of medicines at the Puskesmas are factors that cause referrals for non-specialist diseases to advanced health facilities from the Puskesmas in Polewali Mandar Regency. So it is recommended for the Community Health Center to provide outreach regarding the tiered referral system, and it is recommended that the government and the Community Health Center synergize to complete the facilities and infrastructure as well as medicines at the Community Health Center.