Strategic decision-making processes in universities, as centers of knowledge production and education, play a vital role in societal development. However, structural and procedural pathologies in these systems lead to decreased decision quality, implementation delays, and stakeholder dissatisfaction. Identifying and analyzing these pathologies is essential for improving university performance. This research aims to identify and analyze the main pathologies of strategic decision-making processes in universities and to present a comprehensive model for improvement. The main research questions are: What are the primary pathologies of strategic decision-making in universities? How do these pathologies relate to decision quality indicators? And what are the features of an optimal improvement model? This study was conducted using a quantitative-descriptive approach with a survey design. The population consisted of 494 academic managers and leaders from universities in the northwestern region of the country, from which 387 individuals were selected as the final sample (response rate: 78.4%). The data collection instrument was a researcher-made questionnaire based on a five-point Likert scale, with content validity confirmed by 10 experts and reliability calculated with a Cronbach's alpha of 0.85. The results showed that the highest pathologies were related to power centralization (mean = 3.90) and bureaucratic delays (mean = 3.82). Pearson correlation analysis revealed significant negative relationships between pathological variables and decision quality indicators (e.g., lack of transparency with decision quality: r = -0.527, p < 0.001). The multiple regression model explained 66.2% of the variance in decision quality (R² = 0.662, F(4,382) = 187.27, p < 0.001). An independent t-test showed no significant difference between public and private universities (p > 0.05). The pathologies of strategic decision-making in universities are widespread and multidimensional. The proposed model includes four key components: a participatory decision-making structure, an integrated communication system, transparent decision-making processes, and leadership training programs. Implementing this model could lead to a 20% to 40% improvement in various decision quality indicators. The findings of this research provide a scientific basis for policymakers and university managers to reform decision-making structures and processes.