The study examined the relationship between Strategic Human Resource Management (SHRM) and organizational performance at Mbale Regional Referral Hospital in Eastern Uganda. The research investigated how SHRM practices influenced service delivery, employee productivity, and overall hospital performance. A cross-sectional survey design was employed, involving 156 hospital staff members including medical personnel, administrative staff, and management. Data were collected through structured questionnaires and analyzed using Pearson correlation and regression analysis. Results revealed a significant positive relationship between SHRM practices and organizational performance (r=0.742, p