Objective: Total quality management (TQM) is a useful tool for improving the perceived service quality to increase the customers' satisfaction (CS) and to maintain their loyalty. The purpose of this study examines TQM in relation to CS and loyalty. Method: A self-administered questionnaire was administered to the inpatients who were treated at the National Cancer Hospital, in Vietnam, in April 2018. A total of 516 documents used the analyzed procedure. The dataset was analyzed via the SPSS software 25.0, and the Amos 25.0. A confirmatory factor analysis was performed to test the structural equation modeling of the proposed hypotheses. Results: TQM directly influences CS and has a positive influence on loyalty. Our findings revealed that TQM is the key factor that directly influences CS and loyalty; CS performs a mediating role in the relationship between TQM and loyalty. Implications: The findings have implications for managers and policymakers that TQM factors include Process, Interaction, and Environment quality should be considered in planning with an aim to increase CS and to maintain their loyalty. Therefore, it increases profits for providers that contribute to sustainable survival in a competitive environment. Besides, satisfaction is a mediator factor of TQM and loyalty, so the service organization should consider customers' satisfaction to maintain loyalty.