This research aims to determine the implementations of Islamic economic principles in financial aspects at Siti Khodijah Muhammadiyah Sepanjang Branch Sidoarjo Hospital. Adiwarman Karim formulated five Islamic economics principles, namely Tauhid (Faith), ‘Adl (Justice), Nubuwwah (Prophethood), Khilafah (Governance), and Ma’ad (Return). Using a descriptive qualitative case study as a research approach while using in-depth interviews with key informants, and Analytic Network Process (ANP) to find which principles implementations are dominant. The Study results show that Siti Khodijah Muhammadiyah Sepanjang Branch Sidoarjo Hospital has not used a full sharia-compliant financial system yet. It has distinctive accounting guidelines, incomes and capitals purely from operating profits, and having special council as sharia supervisor. From ANP analysis, the dominant aspects are Financial Allocation from ‘Adl aspect, Leadership Management from Khilafah aspect, ZISWAF Management from Ma’ad aspect, Amanah from Nubuwwah aspect, and Akidah and Akhlak from Tauhid aspect.Keywords: Islamic economic principles, hospital finance, implementation, ANP