Background: The need for smartification is increasingly recognized in public hospitals, making it crucial to identify the current status, gaps, and factors influencing hospital smartness. Objectives: This study aimed to assess the smartness status of public hospitals and investigate its correlation with hospital characteristics and performance indicators. Methods: This descriptive-analytical cross-sectional study was conducted in seven public hospitals in Alborz Province, Iran, during 2023 - 2024. We assessed the characteristics and performance indicators of the hospitals using a researcher-developed questionnaire and evaluated their smartness status with the standardized "Smart Hospital Evaluation" checklist. Data analysis was performed using SPSS24 software, utilizing independent t-tests, Pearson's correlation, Spearman's correlation, and analysis of variance (ANOVA) tests. Results: The smartness status of the hospitals was found to be moderate, with 71% of hospitals falling into this category. A significant correlation was observed between the smartness of hospital units, the type of hospital (teaching or non-teaching), and the hospital's specialization (specialized or general) (P = 0.013). Significant and direct correlations were also found between information technology and hospital units (P = 0.043), management systems and clinical processes (P = 0.008), and overall smartness and clinical processes (P = 0.049). Conclusions: Public hospitals need improvements in smartness indicators. Factors such as whether the hospital is teaching or non-teaching and whether it is specialized or general should be taken into account. Moreover, hospital smartification efforts should adopt a comprehensive approach, considering all dimensions of smartness.