Loyal customers can benefit the company so that it can support the sustainability of the company. For this reason, the factors determining customer loyalty need attention. Therefore, research is needed on the factors determining customer loyalty which aimsat finding outthe influence of service quality, image, and promotion partially toward customer trust and loyalty; the influence of trust toward patient loyalty in private hospitals in Banten Province. This study used 220 patients in 8 private hospitals in Banten as respondents who were randomly selected. The analysis was carried out using structural equation models (SEM) and processed using the Lisrel 8.80 program. The results of the study prove that the quality of service, promotion, and image of each hospital has effect on patient trust and loyalty; trust has effect on patient loyalty. There are 3 paths, but the dominant path is the path of image-trust-customer loyalty.