The aim of this book was to critically analyze employee perception aspects and how they influence performance appraisal process in one of the hospitals in Uasin Gishu County. The objectives were to examine the effects of perceived unfair, inaccurate and subjective appraisal on performance appraisal process. The research was based on a conceptual framework which had performance appraisal as the dependent variable while performance appraisal, fairness and accuracy were the independent variables. The outcome is that there is a direct relation between performance appraisal and the various perception aspects. The conclusion is that if the performance appraisal process is perceived to be fair, accurate and objective then the employees are likely to take the feedback positively thus leading to overall success of the entire performance appraisal process.