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The study aimed to determine the factors that influence the quality of midwifery performance from the perspective of midwives in governmental hospitals in the Gaza Strip. Subjects and methods: A cross-sectional study was conducted using a representative census sampling of 212 midwives and nurses working in the maternity departments of governmental hospitals in the Gaza Strip. A questionnaire was developed, achieving a response rate of 91.9%. The questionnaire was validated by experts, and reliability was confirmed using Cronbach's alpha coefficient. Data were analyzed using SPSS. Results: The study revealed that the highest factors positively influencing midwifery performance included high salary levels, interest in performance improvement, motivators, and the application of quality standards. Conversely, the lowest factors positively influencing performance included marriage, the perception that the midwife's job is the same as a nurse's, work pressure, and the absence of a job description. Additionally, there was a significant difference in the quality of midwifery performance between different job titles in governmental hospitals.