This study examined how Internet of Things (IoT) technologies affect real-time visibility and operational efficiency in Rwanda’s public health supply chain. Guided by Systems, TOE, and SCOR frameworks, we used a convergent mixed-methods design in Kigali across three strata: Rwanda Medical Supply (RMS), public hospitals, and primary health facilities. A stratified purposive sample of 100 professionals (pharmacists, logistics, IT, procurement, store managers) completed a structured questionnaire (Cronbach’s α = 0.82) capturing stockouts, inventory accuracy, delivery lead times, and system integration; semistructured interviews, document reviews, and site observations provided qualitative depth. Quantitative data were analyzed with descriptive and inferential statistics; qualitative data underwent thematic analysis, with joint displays used for triangulation. IoT adoption is meaningful but uneven: 58% of facilities report using IoT (primarily RFID/barcode and cloud dashboards). Where implemented, performance improves; facility records and perceptions indicate ≈25% fewer stockouts, higher inventory accuracy, 72% reporting improved real-time stock visibility, and 74% confirming real-time delivery tracking. Human factors are favorable: between 70% and 77% endorse usability and openness to new tools; 68% report at least moderate confidence. However, only 53% perceive adequate technical support. Training is pivotal: 62% received formal IoT training and most link it to higher efficiency (76%) and better data accuracy (73%). Educational preparedness correlates moderately with IoT proficiency (r ≈ 0.45), highlighting curriculum gaps. Equity remains the main constraint: 40% rate digital infrastructure as fair or poor, and effectiveness is perceived as lower in rural settings. The study concludes that IoT can measurably strengthen Rwanda’s health logistics, but scale-up requires sustained training, robust technical support, interoperability, and equity-oriented infrastructure investment. Future work should assess cost-effectiveness, long-term patient outcomes, and integration with national digital platforms to enable resilient, system-wide impact.