Devolution of healthcare is supposed to influence the health system performs by reassigning authority and responsibility to governments that are elected locally. The purpose of this survey was to determine theimpact of devolution of health services on hospitals infrastructure in Kenya: the case of Mandera County. The survey was steered by the subsequent study objectives: To determine how devolution of health service has influenced health physical infrastructure in Mandera County, to evaluate the effect of devolution of health services on connectivity of ICT in Mandera County health facilities, to determine how devolution of healthcare services affects water infrastructure and to evaluate the effect of devolution on medical equipment in the health facilities of Mandera County. The study was based on two theories: Heresy and Blanchard’s Life Cycle Theory of Leadership and Public Management Theory. Descriptive research design was used in this study. The study aimed at gathering data from the County Government officers, officials and the management from the health sector and various health departments’ employees. The study utilized primary and secondary sources of data, where primary sources of data was collected from semi-structured questionnaires and secondary sources was collected from journal articles, Government reports, theses, dissertation, and books. The population under constituted the entire health system personnel within Mandera County government: The County health executives i.e. the CEC Health, the Chief officer who is the accounting officer for health in the County, head of various health departments, medical officers, clinical officers, the pharmacists, laboratory technologists, Nurses and social workers working in the hospitals and health facilities. Stratified sampling technique was adopted as it is appropriate when  the  population  of interest  is  not  homogeneous;  in  this  particular  case  the  population  of  concern  consists  of different employee  groups,  is  above 10%  of  the  target  population  and  exceeds  30 elements. Editing was done on the questionnaires that were completed to ensure they are complete and consistent. Computable data gathered was evaluated by adopting descriptive statistics method using SPSS. The information was displayed by use of bar charts and diagrams. The research further adopted inferential analysis which was key in measuring the magnitude of association between the study variables. The study was able to obtain a response rate of 89%. The results of the study indicated that there was a positive effect of devolution of healthcare services on the hospital infrastructure in Mandera County. The findings of the research showed a moderate positive effect of devolution of healthcare services on physical infrastructure as shown by a p-value = .511, Sig = .000.  The findings of the research showed a strong positive effect of devolution of healthcare services on water connectivity as shown by a p-value = .846, Sig = .000. The study recommends that the county government should adopt better linkages with donor agencies and the national government towards promoting better healthcare service provision within county governments. The study further recommends that health institutions should expand the health management systems as a way of enhancing service delivery and promote universal healthcare coverage.