Background In many developing countries, including Vietnam, little is known about job satisfaction among lower level‐health staff. The purpose of this study was to assess job satisfaction and its determinants among district hospital health staff. Methods In a cross‐sectional quantitative study, 128 health staff from a rural district hospital in Northern Vietnam were approached for data collection. Regression techniques were adopted to assess factors associated with several types of job satisfaction. Results Overall job satisfaction was moderately high, ranging from 69% to 91%. Across all dimensions, health workers showed their highest satisfaction with co‐worker relationships, while, in comparison, it was much lower for their supervisor's style and relationship. However, they claimed their lowest satisfaction with compensation and benefits. In final multivariate models, females and those satisfied with knowledge, skills and job performance were most likely to be satisfied with relationships with co‐workers. Staff who were married, received a low pay, who were not satisfied with supervisor style and relationships and who were not satisfied with staff training, development opportunities were least likely to be satisfied with compensation and benefits. Conclusions The study findings highlight an important need for designing an intervention program that considers organizational factors. Copyright © 2016 John Wiley & Sons, Ltd.