The Singaparna Medita Citrautama Regional General Hospital (SMC) in Tasikmalaya Regency is a hospital that seeks to improve the quality of human resources that are competitive, have good character and are ready to become a mainstay general hospital in referral health services, providing quality, friendly, comfortable hospital services and accountable, with the motto of serving patients with a smile and a sincere heart. Hospitals need a good performance to achieve these goals, to find out and improve hospital performance, a comprehensive performance assessment is needed from financial and non-financial aspects. The problem in the research is formulated as follows: how is the performance of the SMC Hospital in Tasikmalaya Regency for the 2018-2021 period based on the Balanced Scorecard. The assessment is carried out on four perspectives, namely financial perspective, customer perspective, internal business perspective, and growth and learning perspective. The type of research used is mixed research, which is a research step by combining two forms of research, namely quantitative and qualitative research, the data collected are secondary data and primary data. Secondary data was obtained from the documentation of financial statements, medical record reports, and employment reports. Primary data were obtained through interviews with management and distributing questionnaires to hospital civil servants. The results show that the performance of the financial perspective has been economical and efficient in 2018-2021, while the financial performance has also been effective in 2018-2021. The hospital's performance from the customer perspective for the percentage of customer retention and customer acquisition has been good. Performance from an internal business perspective in 2018-2021 is not good where the percentage values of BOR, BTO, TOI, are not in accordance with the standards of the Ministry of Health. Performance from a growth and learning perspective shows a good percentage in 2018-2021.