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Evidences point to the idea that organizational image may be influenced by patients' perception of service quality, and in turn may influence their expectations. The main aim of this research is to analyse the influence of perceived quality on patients' satisfaction and to evaluate the potential mediating effect that organizational image may have on the relationship between both constructs, in the specific context of primary health care. A structural equation modelling approach was applied to data collected on Portuguese primary healthcare units. Results show that perceived service quality has both positive direct and indirect effects on satisfaction, confirming the partial mediation role played by organizational image in the relationship between service quality and customer satisfaction and highlighting the importance for healthcare units' administrators to manage both the service quality and the image of the institution.