Optimal quality of care remains an integral formal service along the continuum of care pathway. Patient satisfaction is an important health system responsiveness goal which has been shown to influence quality of care except in the indigenous settings. This study identified the determinants of patient satisfaction in the context of indigenous palliative care in Kenya. A descriptive cross-sectional study was conducted among cancer patients exiting indigenous care outlets located in 12 towns across Kenya using a structured modular questionnaire. Exit interviews were undertaken with 433 respondents leaving 193 mapped indigenous outlets. Overall services satisfaction was assessed as the dependent variable using a computed single-item satisfaction mean score. The data was analyzed using IBM Statistical Package for Social Sciences version 22. 0. Bivariate and multivariate analyses were conducted to identify the potential determinants. Against the 433 study respondents, 248 (57.3%) expressed overall satisfaction with indigenous palliative care services: Satisfaction was positively associated with waiting time (AOR = 2.663, 95% CI = 1.235-5.743), provider attention (AOR = 3.698, 95% CI = 1.657-8.254), provider politeness (AOR = 6.774, 95% CI = 3.697-12.413) and provider social communication skills (AOR = 6.520, 95% CI = 3.642-11.673). Good patient-provider interaction, provider social skills and service waiting time influence patient satisfaction with indigenous palliative care. The finding contributes to the understanding of indigenous palliative cancer care and provides scientific evidence for providers and policy makers to redesign and improve their service and outlet setting to provide patient centered holistic palliative care.