Penelitian ini menganalisis anteseden dari Overall Service Quality (OSQ) pada klinik estetik dan efeknya terhadap Intention to Recommend (ITR), yang dimediasi Patient Satisfaction (PST) dan dimoderasi oleh Clinic Iimage (CLI). Variabel OSQ berlaku sebagai High Order Construct (HOC) dengan 6 dimensi yang menjadi Low Order Construct (LOC) yaitu Technical Quality, Procedural Quality, Personnel Quality, Infrastructural Quality, Social Support Quality, dan Interactional Quality. Penelitian ini dilakukan dengan metode survei kuantitatif dimana data diperoleh secara cross- sectional dengan purposive sampling. Responden merupakan pasien yang telah menerima perawatan di Klinik Estetik Z Glow, selanjutnya data dianalisis menggunakan Partial Least Squares-Structural Equation Modeling (PLS-SEM) dengan pendekatan disjoint two stage untuk menguji hirarki model. Hasil penelitian menunjukkan bahwa OSQ secara signifikan mempengaruhi PST (b=0.833, p-value = 0.000), yang pada secara positif mempengaruhi ITR klinik (b= 0.240, p-value = 0.038). PST ditemukan juga mempunyai pengaruh langsung pada ITR (b=0,240, p- value=0,038) Selain itu diketahui CLI tidak terbukti secara signifikan memoderasi hubungan antara OSQ dan ITR (koefisien standar = 0.102, p-value = 0.273). Model ini menunjukkan explanatory power dengan nilai R-squared substantial sebesar 0.745 dan Q2_predict=0,679 untuk ITR. Lebih lanjut dari cross-validated predictive ability test (CVPAT) diketahu model mempunyai strong predictive validity . Hasil penelitian ini menunjuk dimensi technical quality disertai dengan social support quality dan interactional quality menunjukkan hubungan yang kuat dalam merefleksikan OSQ. Temuan tersebut dapat menkadi masukan bagi manajer klinik estetik dalam meningkatkan pelayanan di klinik estetik./This study explores the antecedents of Overall Service Quality (OSQ) in an aesthetic clinic and its effect on Intention to Recommend (ITR), mediated by Patient Satisfaction (PST) and moderated by Clinic Image (CLI). The OSQ variable is treated as a High Order Construct (HOC) with six dimensions as Low Order Constructs (LOC), namely Technical Quality, Procedural Quality, Personnel Quality, Infrastructural Quality, Social Support Quality, and Interactional Quality. The study employs a quantitative survey method, collecting cross-sectional data through purposive sampling. Respondents are patients who have received treatment at Z Glow Aesthetic Clinic. Data is analyzed using Partial Least Squares-Structural Equation Modeling (PLS-SEM) with a disjoint two-stage approach to test the hierarchical model. The results show that OSQ significantly affects PST (β=0.833, p-value = 0.000), which positively influences the clinic's ITR (β= 0.240, p-value = 0.038). PST also has a direct effect on ITR (β=0.240, p-value=0.038). Additionally, CLI does not significantly moderate the relationship between OSQ and ITR (standard coefficient = 0.102, p-value = 0.273). This model demonstrates substantial explanatory power with an R-squared value of 0.745 and Q2_predict=0.679 for ITR. Furthermore, the cross-validated predictive ability test (CVPAT) indicates that the model has strong predictive validity. The findings suggest that the dimensions of technical quality, social support quality, and interactional quality have a strong relationship in reflecting OSQ. These insights can serve as input for aesthetic clinic managers in improving services at aesthetic clinics.