This thesis reviewed recent hospital mergers in Gothenburg, Sweden, and Reykjavik, Iceland, and describes, analyzes, compares, and assesses those mergers. The study focused on the underlying reasons for the mergers, examining both the methods used in the merging process and the merger outcomes. Background information includes organizational theory regarding mergers, hospitals as professional bureaucracies, organizational change and communication, and quality and efficiency in organizations. The study is based on secondary data derived mainly from official documents, evaluations, and research reports. While the study determined similar reasons—mainly economic—underpinning both mergers, the processes differed. The Swedish merger was much better prepared, more radical, and invested more time and money in its process compared to the Icelandic merger, which was less radical and characterized by decisions from the top. Interestingly, the Icelandic merger, which sought to curtail the growth of expenditures but did not demand savings, achieved outcomes that reflected its main goals. Conversely, the Swedish merger sought unrealistic savings in its goals and the savings demands made it impossible for the management team to gain other objectives of the merger, like better service, quality and more competent institution.