Inadequate signage systems and architectural design create physical barriers that cause uneven access to users of hospital buildings during wayfinding, which causes stress, uncertainty, and an unpleasant experience for both staff and patients. The study examines the effects of signs on wayfinding behaviour to achieve inclusive wayfinding in the design of hospitals in Nigeria. The study was conducted at the University of Ilorin Teaching Hospital (UITH), Ilorin Kwara State, Nigeria. A mixed-methods approach was employed for data collection through a survey administered to 140 participants (70 male and 70 female). Thirty respondents were interviewed, and the hospital buildings were observed. According to the findings, direction signage has the most impact on wayfinding since users rely on it the most to make wayfinding decisions, followed by identification signage (text/support icons) that aids in the recognition of target locations. Also, the result illustrates that signage was supported with pictographs while text was interpreted in the main local language (Yoruba), which enhanced understanding of signs across cultures in the state. As a result, the conceptual design and placement of signage and other inclusive navigation components in the hospital should be purposefully and suitably employed, simplified, useful, and appealing for inclusive access, meaning, and interpretation. The main limitation of this study is the non-utilisation of digital signs and various assistive technologies for impaired (sensory and mobility) people of varied ages and abilities.