Objective. The objective of this paper is to present and provide justification for a framework to improve evidence-informed management decision-making among health service managers. Three research questions informed the study: How have different perspectives influenced how evidence has been defined? What are the barriers to the practice of evidence-informed decision-making (EIDM)? What are the factors that may encourage the application of evidence to guide management decision-making processes? Methods. A literature review was conducted to identify studies that examined the practice of EIDM among health service managers. Information relevant to the three research questions was collectively analysed, compared and contrasted based on their relevance to the EIDM process. Conclusion. Several factors have played different but significant roles in affecting the practice of EIDM among health service managers. Although interaction between these factors is complex, the framework developed in this paper may guide the development of strategies to encourage and improve the utilisation of evidence in management decision-making process. What is known about the topic? EIDM has been promoted as a mechanism for improving the quality of management decisions, and hence better service delivery, effectiveness and efficiency. Previous studies have explored and discussed various factors that may affect the practice of EIDM amongst health service managers. However, a greater understanding of how these factors interact is required so that relevant strategies to promote the increased use of EIDM can be developed. What does this paper add? The paper clarifies ‘evidence’ from the view of both managers and members of the research community. It discusses factors that may affect the practice of EIDM among health service managers and develops a framework to for better understanding of how these factors interact and affect practice at various levels. The framework will guide the development of strategies to encourage the utilisation of evidence among health service managers. What are the implications for practitioners? To encourage the practice of evidence-informed decision-making amongst health service managers, multi-level changes in the system, organisation and individual levels are required. To maximise the benefit and relevance of research evidence, managers should be actively involved in setting research agendas and guiding the appropriate presentation of research findings to meet the needs of potential readers.