Purpose: The purpose of the research is to determine the influence of leadership, work environment, competence and job satisfaction on performance. Research Methodology: This research method is quantitative in nature which is analyzed using the Smart PLS application from the data of the questionnaire results with 205 respondents, it is concluded that leadership, work environment, competence and job satisfaction directly and significantly affect the performance at the UPT Kundur Island Health Center, Karimun Regency. Results: it is concluded that leadership, work environment, competence and job satisfaction directly and significantly affect the performance at the UPT Kundur Island Health Center, Karimun Regency. Leadership, work environment, competence directly and significantly affect the performance at the Kundur Island Health Center UPT, Karimun Regency. As for the indirect influence of Leadership, Work Environment and competence on performance through job satisfaction. Recommendation: In this case, it is recommended to the head of the Kundur Island Health Center, namely 1). Optimizing the number of employees so that they can work optimally so that the resulting performance becomes better and on target by carrying out training or education related to their performance, 2). Strive to maintain a comfortable and safe work environment and be able to make employees feel at home at work, 3) Optimize existing competencies in accordance with the duties and responsibilities given in order to be able to keep up with technological developments up to date. So that it makes employees feel the attention of the leadership and the comfort of the work environment and supported by good competence so that employees feel job satisfaction in order to produce optimal performance.