BACKGROUND: Cross-sectoral collaborative organizations (e.g., alliances, coalitions) bring together members from different industry sectors to ameliorate multifaceted problems in local communities. The ability to leverage the diverse knowledge and skills of these members is predicated on their sustained participation, which research has shown to be a significant challenge. PURPOSE: The purpose of this study was to investigate how alliance member perceptions of decision-making influence relate to sustained participation in the alliance and its activities. METHODOLOGY: An Internet-based survey of 638 members of 15 multistakeholder health care alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program was conducted. Ordinal logistic regression path analysis was used to estimate the relationship between two types of influence (personal influence and general stakeholder influence), perceived value of alliance participation, and intentions regarding future participation. FINDINGS: Alliance members saw less participation value when their personal influence was believed to be lower than the influence of other alliance members (b = -0.09, p < .05). This type of influence was not significantly associated with the anticipated level of future participation. In contrast, imbalances in general stakeholder group influence was not significantly associated with perceived value, but greater imbalances were associated with a decreased likelihood of future participation (OR = 0.52, 95% CI [0.32, 0.83]). PRACTICE IMPLICATIONS: Our findings highlight the important yet complicated task of balancing perceptions of influence; leaders must keep the desired outcomes in mind when considering what type of influence to attend to.