Background: Public hospitals play a pivotal role in providing free healthcare services, especially in low- and middle-income communities. These institutions are fundamental to ensuring equitable healthcare access, reducing health disparities, and promoting positive health outcomes. Despite their critical role, public hospitals face numerous challenges, including resource constraints, overcrowding, and the increasing burden of non-communicable diseases. Aim: This paper aims to explore the role of public hospitals in delivering free healthcare services, assess their impact on healthcare accessibility and community health outcomes, and identify challenges and strategies for enhancing their efficiency and effectiveness. Methods: A mixed-methods approach was utilized, combining quantitative analysis of patient data from public hospitals with qualitative insights drawn from case studies and policy reviews. Data sources included government reports, patient satisfaction surveys, and academic literature on public healthcare systems. Results: Findings indicate that public hospitals significantly improve healthcare accessibility, particularly for underserved populations. Quantitative data reveal increased patient admissions and improved health outcomes, while qualitative analysis highlights the role of public hospitals in reducing financial barriers and fostering health equity. However, systemic challenges such as funding shortages, staff shortages, and infrastructural deficits hinder their efficiency and quality of care.