|The need for enhanced performance standards in healthcare institutions in Kenya has necessitated implementation of performance management systems that serve as a guide to and check for performance. This has been instigated by the shortfalls in performance reported and cases of poor service delivery in healthcare institutions in Kenya. This study, therefore, aimed at establishing the influence of performance management systems on performance of public health institutions, withCoast Provincial General Hospital (CPGH), being the case study. Specifically, the research focused on strategic congruence, validity, reliability, acceptance and specificity of the performance management system and their influence on performance of public health institutions in Kenya. Descriptive survey research design was used to obtain the respondents’ views on the influence of the performance management system on the hospital’s performance. The study was a census comprising of 45 Heads of Departments at CPGH.Primary data was used in this study. Structured questionnaires were used to collect views on the performance management system from the respondents .The questionnaire was subjected to pre-test to ensure both validity and reliability. The data collected was edited, coded and analysed using SPSS. Descriptive and inferential statistics were used for data analysis. The relationship between the research variables was tested by use of correlation and regression analysis. From the results obtained, it was established that performance management systems have a significant influence on the performance of public health institutions. It was also established that a significant positive relationship existed between specificity and performance of CPGH. The study howeverfound no significant relationship between strategic congruence, viability, reliability and acceptability on the performance of CPGH. Since overall, the study established a significant positive relationship between performance management systems and performance of CPGH, it was, therefore,concluded that establishing performance management systems in the public health institutions is crucial, as it helps continuously monitor employees’ performance, identify skill gaps and develop required competencies.The research recommends that CPGH implement performance management systems with emphasis on specificity. Further research focusing on other sectors needs to be carried out since this study was limited to only healthcare institutions.