This article aims to depict a clear picture of health service delivery at local level in Nepal. Specifically, it tries to analyze on people's awareness for the health; accessibility to health institutions; people's involvement to promote health service the structural pattern for the health service delivery and their expenditure for health service. Moreover, it explores public health worker's readiness to deliver the health services, monitoring and evaluation of health institutions and associated problems. \nThis study adopted both quantitative and qualitative methods. The primary data/information was collected through semi-structured questionnaires to 54 local respondents and seven health workers belong to Wangsing VDC and Chilaunebash VDC of Syangja District in Western Development Region of Nepal. Besides, seven health workers, six local leaders of the same VDS were interviewed. Secondary information was collected from sources such as Nepal's government's appropriate documents and local health offices. Thus collected data were analyzed by regions (public health post basis), age, literacy level and ethnic composition of the society. \n\nGON has committed to provide the health service at the door steps of the people and devised the policies in line with its commitment in national and international arena. However, finding of this study is that the health service delivery seems insufficient and ineffective at local level in Nepal. This is due to absenteeism of health workers at the health posts; no training to the Village Health Workers (VHW); heavy dependency of people on domestic healing practices; lack of health education; unsuitable location of health post lack of medicines and equipments and etc particularly in the public sectors. Besides, private sectors are also not ready to provide health service to rural people due to attitudinal problems of the people as well as financial reasons. Moreover, civil society organizations' services at local level are based on the donor supports. These organizations have not been continuing their service delivery on the absence of donor support.