Objective: The aim of this study is to evaluate Alberta's health system performance using a balanced scorecard approach. Methods: Comparable indicators of health outcome, quality of care and health service accessibility available on the websites of Canadian Institute of Health Information and Alberta Health and Wellness were analyzed. In total, 36 indicators of Alberta were relatively compared to the corresponding average and best numbers of Canada. Results: Alberta's health system generally performed slightly better than the country's average (103%) but significantly lower than the country's best (79%). Among the comparable indicators, 15 were under the country's average and only 3 were equal to the best, indicating that there is a long way ahead for Alberta's Health System to become the best in terms of comprehensive performance in Canada. The study also identified the worst five indicators of Alberta in comparison with the country's average. They were infant mortality, potential years of life lost due to unintentional injuries, potential years of life lost due to suicides, mortality for prostate cancers, and mortality for all strokes. A further analysis on these 5 indicators across 9 regions of residence in Alberta showed that regions with the highest number (rate) of infant mortality was Capital (East Central), mortality for transport accidents was Calgary (Peach Country), mortality for falls was Capital (Palliser), mortality for suicides as well as for strokes was Capital (Aspen), and mortality for prostate cancers was Calgary (Northern Lights). Conclusion: We suggest that this information should be considered when setting priority for planning of the province's health system.