Background: The decision-making process for selecting a hospital for elective general surgery involves multiple factors, including the quality of medical care, hospital reputation, cost, and patient experience. Understanding these factors is critical for healthcare providers to enhance patient satisfaction and optimize service delivery.This study aims to identify and analyze the factors influencing hospital choice among patients undergoing elective general surgery at ESIC Medical College and Hospital, Bihar. Methods: A total of 302 patients scheduled for elective general surgery participated in the study. Data were collected using a validated questionnaire assessing demographics, hospital-related factors, surgeon-related factors, hospital accreditation, amenities, and academia. Statistical analysis was performed using SPSS version 23, with descriptive statistics and Pearson chi-square tests to compare responses by gender. Results: The most critical factors influencing hospital choice were affordability (86.1%), surgeon’s skills (92.7%), and the surgeon’s attitude towards patients (89.4%). Hospital-related factors such as previous reputation (76.2%) and familiarity (72.8%) were also significant. Facilities and amenities provided by the hospital (69.5%) and accreditation (56.3%) influenced patient decisions. No statistically significant differences were found between male and female participants in their responses. Conclusion: Affordability, surgeon competence, and patient experience are paramount in influencing hospital choice for elective surgeries. Hospital reputation and amenities also play a crucial role. Understanding these factors can help hospital administrators improve patient satisfaction and attract more patients. Recommendations: Hospital administrators should focus on maintaining high standards of clinical care, ensuring affordability, and enhancing patient experience through improved communication and facilities. Efforts to build and maintain a positive hospital reputation are also essential.