The purpose of this study is to analyze the influence of Islamic work ethic, leadership style, organizational culture, and work motivation on employee performance with job satisfaction as an intervening variable. The questionnaire is used as a data collection tool. The purposive sampling method used 72 samples of medical personnel at the Islamic Hospital of Fatimah Cilacap with 261 total medical personnel. Data were analyzed in two separate but sequential stages using structural equation modeling with partial least quadrant approach. The results revealed that Islamic work ethic and work motivation directly to performance have a positive and significant relationship, whereas job satisfaction as an intervening variable of Islamic work ethic, leadership style, organizational culture and work motivation on employee performance has a positive but insignificant relationship because the result of job satisfaction on performance is weak (original sample estimate 0.329; T-statistic 3.906)