A performance review program is a management tool for enhancing the performance of employees. Such systems have been widely adopted by both private and public organisations during the last decade. Management writers strongly advocate the involvement of senior managers in performance review programs. In order to investigate the extent to which senior managers within public hospitals in New South Wales are presently involved in such programs, a survey was conducted. The aims of the survey were: to determine the number of senior hospital managers currently participating in a performance review program; to investigate the methodologies being used within hospitals to evaluate the performance of senior managers; to examine the reasons why hospitals with a formal performance review program in place had implemented that system; and to ascertain the reasons why some hospitals had failed to establish a formal performance review system for senior managers. The most frequently used methodology employed was based on the management-by-objectives model. The findings indicate that further education of those who influence the management of hospitals regarding the benefits of involving senior executives in performance review programs is necessary.