Community participation has been recognized as a crucial component in improving health service delivery and outcomes in rural Uganda. This study examined the relationship between community participation and performance outcomes at health centres in Kayunga District. The study assessed how community participation influenced performance outcomes at selected health centres in Kayunga District. A cross-sectional study design was employed involving 114 respondents from selected health centres in Kayunga District. The sample comprised health centre managers, assistant managers, department heads, administrative staff, medical staff, community health workers, patients, Ministry of Health officials, local government officials, community leaders, and board of governors. Data were collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using SPSS version 25, while qualitative data underwent thematic analysis. Pearson correlation coefficient was used to determine the relationship between variables. The study found a strong positive correlation (r = 0.768, p < 0.001) between community participation and health centre performance outcomes. Community involvement in health planning showed significant association with service delivery efficiency (r = 0.694, p < 0.001). Health centres with active community engagement recorded 72.4% higher patient satisfaction rates compared to those with minimal community involvement. Resource mobilization through community participation contributed to 63.2% improvement in infrastructure maintenance. Community health education programs were associated with 51.8% increase in service utilization rates and 48.6% reduction in preventable disease cases. Community participation significantly improved performance outcomes at health centres in Kayunga District. The findings demonstrated that active community engagement in health planning, resource mobilization, service monitoring, and health education positively influenced service delivery, patient satisfaction, infrastructure development, and health outcomes. Health centre management should strengthen community participation mechanisms through regular stakeholder meetings, establish functional community health committees with clear terms of reference, and integrate community feedback systems into service delivery frameworks. The Ministry of Health should develop policies that mandate community involvement in health facility governance, allocate resources for community mobilization activities, and establish performance indicators that incorporate community participation metrics.