Patients’ expectations and efficient management of waiting time in outpatient departments are crucial for better service delivery. Turnaround time encompassing waiting and consultation periods, serves as a benchmark for workforce efficiency. Time-motion studies systematically observe, measure, and analyze time spent on tasks, improving workflow and productivity.To assess patient satisfaction in relation to waiting time until discharge at the outpatient department of a government tertiary hospital.An institution-based, cross-sectional, observational study was conducted at the outpatient department in a tertiary hospital for one month. A combined chart and video surveillance reviews were used to track time motion. A pretested semi-structured questionnaire was used for the satisfaction survey. Sociodemographic data, time spent per service station (triaging, registration, printing of records, consultation, and discharge), and patient satisfaction were collected. Descriptive statistics summarized turnaround times, and one-sample t-tests compared observed times with recommended standards. Patient satisfaction was measured on a 4-point Likert scale, and Spearman’s rho correlated waiting times with satisfaction. Among 339 respondents, most were middle-aged, 40–59 years, female, and unemployed. The longest delays occurred in registration to printing of records (mean = 66 ± 34.68 min) and printing of records to being called for consultation (mean = 72 ± 53.55 min). Observed processing times significantly exceeded recommended standards (p <0.001). Spearman’s correlation demonstrated negative associations between waiting time and patient satisfaction across all stations (⍴= −0.26 to −0.42, p <0.001), with the strongest effects at triaging and pre-consultation steps. Nursing and physician care were rated highly (very good to very satisfied). Findings demonstrate an inverse relationship between waiting time and patient satisfaction in outpatient settings. This suggests pre-consultation delays are primary determinants of patient satisfaction, even when nursing and physician care were rated positively. Longer waiting times in triaging and clinics before consultations negatively impacted patient satisfaction. Despite delays, nursing and physician care were highly rated, indicating dissatisfaction from system inefficiencies rather than clinical interactions. Improving workflow efficiency while maintaining high-quality care is crucial for enhancing OPD patient experience and adherence to service standards. Keywords: Outpatient, patient satisfaction, time-motion study