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Objective (s): Hospital accreditation is a good strategy for improving the quality, safety, effectiveness and efficiency of hospital services. This study aimed to evaluate hospital accreditation implementation in Iran. Methods: This descriptive, and cross sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 hospital managers in Iran. Overall, 547 hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis. Data analysis was conducted with SPSS 18.0 using descriptive and inferential statistics. Results: The mean score of managers’ satisfaction of hospital accreditation implementation was 2.44+0.70 out of 5 (low). About 10 percent of managers were satisfied with the hospital accreditation implementation. Hospital managers were satisfied with employees’ engagement in applying accreditation standards and the medical university support. Most complaints were related to lack of human, financial and physical resources. Physical resources, medical university support and the hospital information system had the most effect on successful accreditation implementation. There was significant association with accreditation scores and using quality management models in the hospital. Conclusion: Hospital managers are facing time and resources shortage in implementing accreditation. Necessary resources should be provided if improvement in the quality of hospital services is required.