This research lunched to determine to what extent decentralization influences nurses autonomy, job satisfaction, and organizational commitment. There are studies which show that decentralization decision making increases productivity, improves moral, increases favorable attitudes, and decrease absenteeism. Decentralization of decision making is often facilitated by participative management strategies whereby individuals thought the organization are given more information, knowledge, and power. This research was conducted in inpatients units Assuit University Hospitals and number of head nurses participated in the study. Data were collected through a questionnaire form including three different tools. The results of the present study revealed that the mean score of head nurses organizational commitment and job satisfaction was and low as regarding to decentralization. There was a direct effect of decentralization on organizational commitment. Decentralization was the only significant predictor of autonomy. Managers should diagnose the organizational situation and select the decision making level that will best meet the organization needs. When determining the optimal degree of decentralization organization, top management needs positive attitudes toward decentralization, they need competent personnel to whom they delegate authority and access information necessary for decision making.