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Cobit 5 provides a comprehensive framework that assists enterprises in achieving their objectives for the governance and management of enterprise information technology (IT). Furthermore, it helps enterprises create optimal value from IT based on the balance between the achieved IT benefits and the optimized risk and resource use. The implementation of e-health governance within health care is very complex project and poorly understood. The paper explores the application of this framework within the health organization in Croatia as well as its impact on e-health governance maturity and strategic alignment with health care. This study used Cobit 5 management guidelines for some of IT related activities in order to help organizations make better e-health investment decisions and strategies.