Perkembangan manajemen mutu di bidang pelayanan kesehatan khususnya pelayanan rumah sakit umum daerah simeulue masih dirasakan kurang. Penelitian bertujuan mengetahui tingkat mutu pelayanan yang dilihat berdasarkan tingkat kesesuaian nilai harapan dan nilai kenyataan terhadap kepuasan pasien yang ditinjau dari dimensi kenyataan (tangible), kehandalan (reliability), ketanggapan (responsiveness), jaminan (ansurance), dan empati (emphaty) yang dilaksanakan di ruang rawat inap kelas III RSUD Simeulue Kabupaten Simeulue Tahun 2020. Penelitian ini deskriptif analitik dengan desain cross sectional. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner. Populasi seluruh pasien dirawat diruang penyakit dalam, ruang obgyn dan ruang bedah RSUD Simeulue Kabupaten Simeulue. sampel 91 responden dengan menggunakan teknik proportional random sampling. Metode analisis kenyataan dan harapan/ importance performance analisis.Hasil penelitian diperoleh bahwa kualitas pelayanan kenyataan terhadap kepuasan pasien rawat inap (86,15%), Kualitas pelayanan kehandalan terhadap kepuasan pasien rawat inap (92,05%), Kualitas pelayanan ketanggapan terhadap kepuasan pasien rawat inap (92,50%),kualitas pelayanan jaminan terhadap kepuasan pasien rawat inap (86,15%),kualitas pelayanan empati terhadap kepuasan pasien rawat inap (91,52%) dan rata-rata pelayanan terhadap kepuasan pasien rawat inap (89,87%). Dengan demikian mutu pelayanan dan kepuasan pasien rawat inap masih dibawah 100%. Melalui kepala RSUD Simeulue diharapkan kepada petugas kesehatan untuk memberikan pelayanan kepada pasien rawat inap dengan sebaik-baiknya dari dan memeriksa kembali sarana dalam pelayanan rawat inap.Kata Kunci : Mutu pelayanan, harapan dan kenyataan, pasien rawat inapThe development of quality management in the field of health services, especially the services of the Simeulue regional general hospital, is still lacking. This study aims to determine the level of service quality which is seen based on the level of conformity of the expected value and the reality value to patient satisfaction in terms of the dimensions of reality (tangible), reliability, responsiveness, assurance, and empathy. in the class III inpatient room at the Simeulue Hospital, Simeulue Regency in 2020.This research was descriptive analytic with cross-sectional design. Data collection was done by interview using a questionnaire. The entire population of patients treated in internal medicine, space obgyn and surgery hospital of Regency. The sample were taken 91 respondents using proportional random sampling technique. The method of analysis of reality and hope/importance performance analysis.The results showed that the quality of service in reality on inpatient satisfaction (86.15%), quality of service reliability on inpatient satisfaction (92.05%), service quality responsiveness to inpatient satisfaction (92.50%), quality of service guarantee service to inpatient satisfaction (86.15%), the quality of empathy service to inpatient satisfaction (91.52%) and the average service to inpatient satisfaction (89.87%). Thus the quality of service and satisfaction of inpatients was still below 100%.Through the head of the Simeulue Hospital, it is hoped that health workers will provide services to inpatients as well as possible from and re-examine the facilities in inpatient services.Keywords: Quality of service, expectations and reality, inpatients