Purpose -The paper aims to provide empirical evidence regarding the relationship between the level of comprehensiveness of a Performance Measurement System (PMS) and its respective organizational effectiveness. The extant literature has highlighted that a PMS may successfully contribute to the implementation of the organizational strategy, with the Balanced Scorecard (BSC) serving as an exemplar of a strategy performance management tool and playing a primary role to this end. However, the reasons for the overall high rate of failure in the implementation of the BSC remain unexplained and, to date, little empirical research exists regarding the design of PMSs such as the BSC and its constituent elements.Design/methodology/approach -Using a survey of 103 Italian managers, the paper advances a model describing a comprehensive BSC design, after identifying the key attributes from the performance management literature. Data were analyzed using cluster analysis and multiple regression analysis.Findings -Results suggest that organizations are implementing the BSC following two different approaches, which vary from a less comprehensive to a more comprehensive design.More importantly, the BSC design explains variation across three organizational effectiveness measures: (1) improvements in translating the organizational strategy into operational goals, (2) understanding cause-effect relationships, and (3) enhancing internal communication among employees. Originality/value -The paper builds on and extends the previous literature on performance management in two ways. First, via a literature review, it introduces a model describing a comprehensive BSC design which includes 12 attributes. Second, it demonstrates that organizational effectiveness varies positively with the level of comprehensiveness of the BSC design.