This study is an ethical investigation into operating paying sections in Malawian public hospitals, and focuses on Zomba Central Hospital (ZCH) as a case study. Zomba Central Hospital is one of the hospitals in Malawi where paying sections are run alongside the non-paying sections. Initially, medical services at this institution were for free at the point of consumption. However, a paying wing was later introduced, although it was also suspended along the way. In 2013, the paying wings were re-introduced at ZCH. This study was conducted to investigate whether or not the distribution of resources at ZCH favours the paying section. The study used utilitarianism ethical theory to investigate the ethics of operating paying wings in public hospital of Zomba Central. Face-to face interviews were conducted to two key informants (Chief Hospital Administrator and the In-charge of the Paying Section). Semi-structured questionnaires were used to gather primary data from five nurses and three doctors. Focus group discussions were conducted with four guardians from paying section and eleven from the non-paying section. The findings of the study show that distribution does not favour the paying section. However, it was found that the system is associated with good and bad things. The good things include: the system does not infringe non-paying patients from accessing healthcare; the system helps to realise money that is used to buy medicine, reagents and other necessities at the institution used for the entire hospital, such as renovation of the hospital structures and motivation of all members of staff. The bad things highlighted were that provision of good meals and accommodation favours the paying section only. The study concludes that the system of operating paying wings in public hospitals is ethical under utilitarianism. This is so because the system does not favour the paying wing in the resource distribution. The other aspect is that the system mitigates the financial gaps created by the underfunding of the institutions.