This chapter discusses hospital engineering services. The major responsibility of the engineering service department is facilities management. The operation, maintenance of all the equipments, machines lies with the engineering service department. The size and functioning of the engineering services department will depend upon the size and type of the hospital. The functions of the department include repair and maintenance of hospital equipment, maintenance and repair of civil structure, electricity provision, distribution, maintenance, water supply system of hospital complex, sewage drainage system of hospital complex. Hospital of 100 beds or more should have a competent graduate engineer, experienced in construction, maintenance of building. In addition to the equipments each area of the hospital, building, electricity, water supply, sewage disposal, computers need urgent attention of the engineering services in the hospital.