The study investigated the prevalence, effectiveness, and contextual factors influencing maintenance strategies in manufacturing firms in Uganda, with a particular focus on predictive maintenance (PdM). The objectives were to identify the current prevalence and sophistication of maintenance strategies, to quantitatively evaluate the impact of PdM techniques on equipment downtime, and to analyze the critical success factors and barriers affecting the effective implementation of PdM programs. Data were collected from 80 manufacturing firms using structured questionnaires, interviews, and equipment performance records. The analysis revealed that reactive maintenance remained common in 35% of firms, preventive maintenance in 40%, and predictive maintenance in only 25%, indicating low adoption of advanced maintenance strategies. Empirical results demonstrated that firms employing PdM techniques, such as vibration analysis, thermal imaging, oil analysis, and ultrasonic testing, experienced significant reductions in equipment downtime, averaging 13.5 hours per month compared to 22 hours under reactive maintenance, representing a 41% reduction. The study also identified that managerial support (72%), financial resources (65%), and technical expertise (60%) were critical success factors for effective PdM implementation, while barriers such as inadequate infrastructure (42%), resistance to organizational change (45%), and limited technical skills (40%) hindered adoption. These findings highlighted that technological adoption alone was insufficient; financial, managerial, and organizational readiness were essential for sustainable PdM programs. It was concluded that predictive maintenance substantially enhanced operational efficiency, reduced unplanned downtime, and extended equipment life, but its adoption in Uganda remained limited due to financial, technical, managerial, and infrastructural constraints. The study recommended that firms strengthen managerial commitment, invest in PdM technologies and workforce training, improve infrastructure, implement pilot programs, foster organizational culture change, and develop sustainable maintenance frameworks. Supporting policies, financial incentives, and knowledge-sharing platforms were also advised to facilitate broader adoption and long-term sustainability of PdM in the manufacturing sector.