The Malaysian public healthcare sector faces rising attrition among Medical Officers (MOs), threatening workforce stability and healthcare delivery. This study investigates key factors influencing MO resignations in Selangor and Kuala Lumpur, focusing on financial compensation, job satisfaction, work environment, organizational culture, and resignation decision-making. Structured questionnaires were distributed via snowball sampling to 212 recently resigned MOs, with data analysed descriptively and statistically using Spearman’s correlation and Chi-square tests. The results indicate that negative organizational culture and financial dissatisfaction are the strongest predictors of attrition, followed by job dissatisfaction and the premeditated intention to leave. Work environment factors, though less direct, amplify existing dissatisfaction. The study recommends salary revisions, cultural reforms through mentorship and leadership accountability, and structured career advancement pathways to reduce the attrition intention among MO in the Malaysian public healthcare sector. These insights support targeted retention strategies vital for sustaining Malaysia’s public healthcare sector. Future research should explore longitudinal and mixed-method designs to further understand MO attrition dynamics.