Over the past two decades, Uganda has implemented a series of public service delivery reforms, including decentralization, results-oriented management, client charters, and the integration of information technology into service provision, all aimed at improving the efficiency, responsiveness, and quality of services delivered to citizens by local government institutions. This study examined the effectiveness of public service delivery reforms and citizens’ satisfaction, using Wakiso District, Uganda as a study area, guided by objectives that sought to assess the level of implementation of key public service delivery reforms within the district, establish citizens’ level of satisfaction with services received, determine the relationship between reform implementation and citizens’ satisfaction, and identify the challenges limiting the effectiveness of these reforms. A descriptive correlational research design combining quantitative and qualitative approaches was adopted, with data collected from a sample of 214 respondents comprising citizens accessing services at district and sub-county offices, district technical staff, and local council leaders, using questionnaires, interviews, and review of service delivery performance records. Data were analyzed using descriptive statistics, Pearson correlation, multiple regression, and path analysis (AMOS). Results showed moderate implementation of service delivery reforms (mean = 3.32) and a significant positive correlation between reform implementation and citizens’ satisfaction (r = 0.586, p < 0.01). Regression analysis showed that reform implementation and service quality jointly explained 43.7 percent of the variance in citizens’ satisfaction (R² = 0.437). Path analysis revealed that perceived service quality significantly mediates the relationship between reform implementation and citizens’ satisfaction, with a significant indirect effect (β = 0.267, p < 0.01) alongside a significant direct effect (β = 0.301, p < 0.01), yielding a total effect of 0.568. The study concludes that public service delivery reforms in Wakiso District have produced a measurable but moderate improvement in citizens’ satisfaction, operating substantially through improvements in perceived service quality, and recommends strengthened implementation monitoring, continued investment in service quality improvements such as reduced waiting times and staff responsiveness, and enhanced citizen feedback mechanisms.