The increasing numbers of public and private hospitals have resulted in the competitive environment in healthcare industry. This situation needs cooperation and support from the hospitals to focus on setting up compelling hospital image and providing satisfaction to the patients to ensure and secure their loyalty. Therefore, providing a high Service Quality will ensure the patients' satisfaction and loyalty to keep on tapping the service provided. This study reports on a research finding that undertakes to analyze the effect of Image and Service Quality provided by the hospital towards patients' satisfaction and loyalty in public hospital in Terengganu. Structural Equation Modelling (SEM) was used to test the proposed hypothesis model in the study. The finding of this study illustrates that although hospital image did not have any effect on the patients' loyalty, but it had a big impact on patients' satisfaction. Furthermore, patients' satisfaction had a big impact towards patients' loyalty. This study also clarifies that the Service Quality provided by the hospital had a direct influence on the patients' satisfaction and loyalty. Hence, a high service quality provided by the hospital will influence patients' satisfaction and loyalty and a positive and compelling hospital image is an important factor to ensure the patients' satisfaction.