This study aimed to assess the overall satisfaction level of patients with the laboratory report issuing counter at tertiary care hospitals in Sri Lanka and to identify socio-demographic and service factors associated with satisfaction. A hospital-based cross sectional, descriptive study was conducted at Teaching Hospital Peradeniya from November 2023 to September 2024 using a convenience sampling technique. Data were collected from 384 patients using a pre-tested, structured questionnaire based on a 5-point Likert scale. Statistical analysis was performed using IBM SPSS version 29.0, including descriptive statistics, chi-square tests, Pearson correlation, and multiple linear regression.  Cronbach’s alpha was 0.880, indicating good internal consistency. The overall mean satisfaction score was 3.38 (SD = 0.70), with individual parameters ranging from 2.74 to 3.61. Patients with a mean score above 3.0 were classified as satisfied; accordingly, 67% of patients were satisfied and 33% were dissatisfied. Employment status (p = 0.009) and number of visits (p = 0.034) were significantly associated with patient satisfaction. Pearson correlation identified adequacy of seating arrangements as strongly correlated with satisfaction (r = 0.678, p < 0.001). Regression analysis revealed that availability of lab staff, respect and courtesy of staff, ease of finding the lab location, lab report loss, lavatory accessibility, and staff–patient interaction were significant predictors of overall satisfaction. Patient satisfaction with the laboratory report issuing counter was moderate. Interpersonal factors and operational efficiency are key determinants of satisfaction. Targeted improvements in staffing, staff behavior, and report management are recommended.