Effective implementation of the primary health care (PHC) approach relies on essential health system inputs, including policies, structures, programs, organization, and governance. Strong health system governance (HSG) plays a critical role in PHC services, directly influencing healthcare delivery. Understanding HSG within the PHC context is crucial for developing and executing health programs that contribute to achieving universal health coverage (UHC). This scoping review examines the impact of health system governance on PHC services and explores its role in advancing equitable and comprehensive healthcare access for all.