The aims of the present study were to assess the level of stress in hospital managers, to determine the sources of stress among hospital managers, and to evaluate the impact of stress on their job performance and, also to identify the relationship between some of the mamagers' personal characterisitcs and their level of stress. To achieve the above objectieves, it was decided to include all of the hospital mamagers (n=79) from Fars and Khozestan provinces in Iran in the study. However only 53 of them agreed to participate and complete the required questionnaires. The fingins revealted that 58% of the mamagers experienced high levels of stress. The rates were 51% and 70% for Fars and Khozestan provinces, respectively. When they were separated according to the type of hospital they managed, i.e. public or private, the percentages were 11.1% and 68.2% respectively. The findings revealed that the ten following factors were the top ranking sources of stress for the mamagers: 1- inflation and high cost of living. 20 Physical condition of working environment, fatigue and work. Related accidents 3- Competitors' success. 4- Difficult to deal with personnel at work. 5- Difficulty of job. 6- Having great responsibility for recovery of patients. 7- Number of tasks that need to be done simulaneously. 8- Shortage of recreational facilities. 9- Low salary. 10- Negative attitude of the community. Based on the above analysis most of the factors causing stress were work related. The rsults also indicated that stress had reduced the mamagers' morale, motivation, quality of their work and had also a negative impact on their baility for effective decision making process.