Abstract: The general objective of this study is to assess the effect of strategic contract management practices on operational and competitive performance of private hospitals in Rwanda. This study refers and uses the theories like Transaction Cost Economics (TCE) Theory, Relational Contracting Theory and Game Theory. The study used descriptive, and correlational research design. Descriptive survey research use surveys to collect information on a variety of issues and correlational studies research design examined at the links that exist between variables under the study. The population of this study was 148 people from Dream Medical Center Hospital. The study used a census inquiry method instead of sampling. This decision is based on the small size of the target population. Statistical Package for Social Sciences (SPSS) version 28 was used in the study. Regression results indicated that strategic contract planning, strategic contract negotiation, and strategic contract execution have significant positive effects on operational and competitive performance of Dream Medical Center Hospital. The coefficient analysis showed that strategic contract planning (B = 0.238, p < 0.05), strategic contract negotiation (B = 0.371, p < 0.05), and strategic contract execution (B = 0.341, p < 0.05) significantly improve organizational performance. The study concludes that effective strategic contract management practices enhance operational and competitive performance of Dream Medical Center Hospital. The study recommends that Dream Medical Center Hospital should strengthen strategic contract planning, negotiation capacity, and contract execution monitoring to improve procurement effectiveness and overall organizational performance.