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This study assesses the availability of the fundamental factors required for the application of the Activity‐Based Costing (ABC) systems in the Palestinian governmental hospitals in Gaza Strip. The study results showed that such main factors as higher management directives, the diversity and complication of therapeutic services, the availability of accounting systems, sharp competition and the diversity of supporting activities are actually present in practical reality and represent an infrastructure for the application of (ABC) systems in those hospitals. The study concluded by making several important recommendations. Namely, the establishment of independent departments of cost accounting in the Palestinian governmental hospital supported by qualified human resources. The adoption of ABC systema because they offer more accurate cost data, provide help in planning and control and facilitate good decision‐making. Finally, the turn towards ABC systems should be gradual, step by step, so that it begins at the department level and ends with the whole hospital.