Patient centered care has become a central for the nation’s healthcare system all over the world. However the major issues facing healthcare systems around the world was not well explored. Therefore this study aims to identify facilitator and barriers to implement patient centered care practice in public hospitals in Benishangul Gumuze regional state, South West Ethiopia, 2019. Methods: Institution based Qualitative case study design was employed. Thirty two purposively selected participants from different category were interviewed. Ethical clearance sheet was obtained from Pawe health science college ethical review board. Seventeen face to face in depth interview, two focused group interview and systematic observation was conducted. Deductive analysis was employed manually to analyze text data. Results: The analysis result yields multiple driving and hindering factors of patient centered care practice. Information related factor, service expansion, feedback mechanism and health policy were identified as facilitators. In contrast patients’ health literacy level, health care provider characteristics, patient empowerment, shortage of resource, organizational capacity, shortage of specialty care, managerial skill, legislation related factor and organizational culture are identified as a barrier to practice patient centered care. Conclusion: Patient centered care practice in public hospitals had cheaply driven or hindered by multiple factors. Patient health literacy level, patient empowerment, and family and friend involvement in patient care were perceived as a tough barriers. Investing on the improvement of patient health literacy and patient empowerment may fasten the transformation of the current health care practice in to patient centered care practice in the healthcare settings…Readmore