Introduction: Environmental health program is preventive in activities to improve environmental health quality hence it is useful to improve life quality and human health and is in accord with Kepmenkes RI No 1428/2006 and this environmental health program is mandatory to perform in Puskesmas. Objective: The study was to elaboratie the difference of environmental health program implementation between urban Public Health Care (PHC) and rural PHC, difference of environmental health program performance output based on environmental health staff and availability and feedback giving among PHCs. Methods: Comparative analysis through descriptive method is in form of Rifaskes 2011 table and graphic from secondary data. Population was PHC in Tuban District and it was used as total sample and PHC as analysis unit. Result: PHC in Tuban Regency had not been optimum in performing all environmental health programs. Difference between urban and rural PHCs were the urban PHC didn't perform all kesling program while the rural PHC performed all environmental health program albeit non maximum. There was difference between sanitarian staff availability between PHCs including in reaching output and there was difference between PHCs that perform performance assessment by obtaining feedback only 9 (27%) PHCs, and feedback benefit had not been influencing environmental health program performance improvement. Less than 50% PHC obtained performance “good” category on public places assessment and other environmental health program was still categorized “poor.” Conclusion: There was difference of environmental health program implementation among PHCs and sanitary staff availability that still lack and feedback benefit had not been effecting environmental health program performance improvement.