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Lean hospital is a method that aims to continuously increasing value-added activities compared to non-value added activities and waste (the value to waste-ratio). The average waiting time in providing outpatient medical records in RSUD Kota Makassar was 28.39 minutes. This result is still below the Minimum Service Standard (SPM) for the time of providing medical record files that is 10 minutes. The purpose of this study is to analyze the process of providing medical records for outpatients by using lean approach in RSUD Kota Makassar. This research was a mixed method study with Sequential Explanatory study design. Sequential Explanatory is characterized by collecting and analyzing quantitative data in the first stage (i.e. average, highest, and lowest time of each activity), then followed by collecting and analyzing qualitative data in the second stage (i.e. kind of activity, waste identification, and input aspects). 30 respondents of outpatient were chosen for quantitative data and 6 informants for qualitative data. The finding shows that only 22% value-added activities and remained 78% non-value added activities in the process of providing medical record files. Four of eight types of waste were found in the process of providing medical record files, namely; overproduction, waiting, extra-processing, and defects. Fishbone diagram was employed for the root cause analysis. Aspects that affects are men, method, machine, and environment. For improvement suggestions, lean tools were included such as seiri, seiton, shitsuke, visual management, kaizen, and error proofing. The conclusion of this study is that the process of providing medical records for outpatients in RSUD Kota Makassar was still considered in Un-Lean Enterprise. It is recommended to reduce waiting time by conducting more stringent supervision of arrival time of officers and renew the Hospital Management Information System in order to fully integrate among units or counters. Keywords: Lean Hospitals, Value-added, waste