The study aimed at establishing the influence of decentralization on health service delivery in Katwe-Butego Sub County -Masaka District. The objectives of the study were, to determine the level of decentralization in the health service delivery in Katwe-Butego Subcounty -Masaka District, to establish the role of decentralization in health service delivery in Katwe-Butego Subcounty —Masaka District, and to establish the relationship between decentralization and health service delivery in Katwe-Butego Sub County -Masaka District. The study was designed to investigate the effects of Decentralization on health service delivery in the Masaka district. The study was sectional involving both males and females and descriptive in nature aiming at giving a detailed account of views, impression, attitude and interpretation of issues on health welfare of the people. The comprised of one hundred twenty (120) respondents, to be selected from the ratio of 40 staff members, 64 respondents from the community members (beneficiaries) and 1 6 local leads respectively. These provided the substantial information about the research topic. Before going to the field for data collection, the researcher got a letter of introduction from the office of the head of department commissioning him to carry out the study with purpose. In addition, the researcher introduced himself to the respondents before administering the questionnaire and have interviews with respondents. The study revealed that the age category 36 - 45 had a 1 5% representation. Age category 46-55 had a total response of 20%, while 26-45 age group was represented by 20% the 20-25 category had a total representation of 25% while the category 56+ had a representation of 20%. This implies that elderly people are less energetic to participate actively in running the daily activities of the district. The study concluded that, determine the level of Decentralization on health service delivery in Katwe-Butego SubCounty -Masaka District.-Uganda have expressed concerns about the startup of the third phase of decentralization through which new responsibilities was devolved from the central government and provincial level to the districts, and sector offices was given new attributions and responsibilities that the districts have managed over the past couple of years. It was recommended that, Katwe-Butego Sub-County -Masaka District need to be represented in the Kampala town Council meetings in order to share with the Town Council members what their Districts plan to do in a particular period. Also the study recommends more research to be carried out on the roles and responsibilities of different organs in the District (District Council, Executive Committee and technical staffs).