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Mechanical, Electrical, and Plumbing Engineering Systems (MEP) Play a Major Role in Enabling Hospitals to Perform their Functions, and in the Comfort, Safety, and Security of their Occupants. They Affect each other and Influence the Design and Execution of the Building’s Architectural and Structural Elements, including the Layout, Elevations, and Plans, in addition to Aspects Pertaining to Structural Systems or Shafts, and Interior Finishes. The Paper Problem is Apparent through the lack of knowledge Relating to the Requirements of different Engineering Service Systems, and the Unawareness of their Impact on each other or on the Architectural and Structural Elements of the Building. This limits Fully Benefiting from such Systems due to Conflicts between them and the Architectural and Structural Elements, in addition to Hindering Making Appropriate Design Decisions related to Operating them causing Deficient Coordination. This Paper Aims to Develop a Methodology for Achieving Integration between Types of Engineering Service Systems and the Architectural and Structural Elements of Hospital Buildings, Leading to Design Decisions that can Attain the Highest Benefit from such Systems and Ensure their Operational Safety according to their Types, Internal Components, Functional Requirements, and their Impact on the Design Decisions for all the Structural Elements of the Building. This is Performed based on a Theoretical and Analytical Study of the Types and Components of Engineering Service Systems (MEP) and Determining their Impact on the Structural Elements and Architectural Components of the Building. The Paper proposes a Methodology that Comprises 12 Stages to Achieve Integration between Engineering Systems and the Structural and Architectural Elements of the Building, according to the Types and Requirements of each System and its Impact on Design Decisions. A set of Tables are also Developed that Represents a Guideline and include Alternatives to the Different Types of Engineering Systems, their Requirements, and Highlight their Impact on the Structural and Architectural Elements of the Building, including the Layout, Plans, Elevations, and Interior Design Elements, in addition to their Relation to other Engineering Systems. The Results also Highlighted the Large Diversity of Types of Mechanical Systems, and the Significant Influence of Electrical Systems on all other Systems. [ABSTRACT FROM AUTHOR]