This study examined the influence of hospital service quality on patient patronage among private hospitals in Port Harcourt, Rivers State, Nigeria. Specifically, it investigated the relationships between empathy and responsiveness as dimensions of hospital service quality and patient patronage measured through patient retention and electronic word-of-mouth (e-WoM). A cross-sectional survey research design was adopted. The study covered 230 management and senior healthcare personnel, including hospital administrators, medical directors, nursing managers and departmental heads, drawn from registered private hospitals in Port Harcourt. A census approach was employed, and data were collected using a structured questionnaire adapted from validated measurement scales. Face and content validity were established through expert review, while reliability was confirmed using Cronbach's alpha coefficients exceeding the recommended threshold. Data were analysed using the Spearman Rank Order Correlation Coefficient at the 5% level of significance. The findings revealed that empathy has a strong positive and statistically significant relationship with patient retention (ρ = 0.801, p < 0.05) and electronic word-of-mouth (ρ = 0.728, p < 0.05). Similarly, responsiveness exhibited significant positive relationships with patient retention (ρ = 0.657, p < 0.05) and electronic word-of-mouth (ρ = 0.778, p < 0.05). These results indicate that compassionate, individualized attention and prompt, responsive healthcare services significantly enhance patients' willingness to continue patronizing private hospitals and recommend them through digital communication channels. Hospital managers should institutionalize empathy-driven service culture, improve responsiveness through streamlined service delivery, and integrate service quality indicators into performance management systems to strengthen patient retention and stimulate positive electronic word-of-mouth.