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Industrialization and domestic activities are very potentially towards water pollution contribution. One of kind domestic activities which producing wastewater is a hospital activity. Public Regional Hospital in Tulungagung is located at Kedungwaru District that will developed in order to further support the existing infrastructure. Assessment towards water quality and load pollution capacity of Ngrowo river as wastewater receiver is very important before hospital development began. The method used in this research was Mass Balance method, Pollution Index to determine of water pollution status in which the analyzed parameters were temperature, pH, TSS, DO, BOD, COD, Nitrate, Phosphate, and then the results of the parameter testing were compared with the water quality standard class II, then the maximum pollutant load was calculated to determine the pollution load capacity. Result show that water quality of Ngrowo River categorized in low pollution (around 3.75 – 3.99 for index pollution) based on class of II of water quality standard. Load pollution capacity at downstream have exceeded 28673.3 kg.day-1 for BOD, 34339.3 kg.day-1 for COD in existing condition. We recommend when a hospital development does exist should find other place to throw away their wastewater because Ngrowo River have polluted even in upstream area.