The study examined the role of job autonomy in enhancing employee performance in Delta State government hospitals. The study adopted Self-Determination Theory as theoretical framework for this study. The study utilized both qualitative and quantitative sources of data. The study revealed that participation in decision-making emerged as another significant predictor of employee performance, as it fosters a sense of ownership, accountability, and commitment to organisational goals. Moreover, clear work criteria, which outline performance expectations and task priorities, were shown to enhance employee confidence and consistency, leading to better outcomes in healthcare service delivery. In conclusion, the study highlights the transformative potential of job autonomy in enhancing employee performance, offering actionable strategies for improving public healthcare systems in Nigeria and beyond. The study recommended that to boost morale and enhance employee commitment, hospital management should involve staff in decision-making processes, especially in areas directly affecting their work. Structured mechanisms, such as staff committees or regular feedback sessions, should be established to gather input on scheduling, resource allocation, and patient care strategies. Hospital administrators should ensure that work criteria are well-defined and effectively communicated to employees. These criteria should outline performance expectations, task priorities, and quality standards to guide staff in their daily operations.