This research paper evaluated the level of effectiveness of facilities management in the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in Bauchi town; the existing scope, strategy, practices & roles, challenges with regard to the effectiveness of their management of facilities, engineering and maintenance services. The state of facilities management in ATBUTH.is presented in the result of this research. The paper critically analyses the inherent challenges of facilities maintenance in ATBUTH in Bauchi town Nigeria. The main challenges of managing the healthcare facilities in ATBUTH are the intricacy of the health facilities. ATBUTH renders specialist services with sophisticated healthcare structures, equipment and machinery that can only be maintained by experts. The study adopted descriptive survey techniques, using the quantitative research approach as considered appropriate. (Amarantunga, Badru et al, 2002). Data was collected through the administration of questionnaires. Eighty (80) questionnaires were distributed to the facilities maintenance managers in ATBUTH. Fifty one (51) questionnaires were completed. The distributions of the respondent were 51 in-house maintenance officers and technicians. Five major indicators of effectiveness of facilities management were assessed such as: Service performance, Capacity building, policies, and supervision. The data was then analyzed by weighing poor, fair, or good and the overall scores were taken to determine the degree of effectiveness of FM in ATBUTH.