Introduction: Estimating the incidence of Dengue Hemorrhagic Fever (DHF) in the future is critical to anticipate the incidence of DHF. This study aims to estimate dengue fever incidence in Makassar City in the next 20 years (2020-2040) using a dynamic systems approach. Methods: This study uses the Research and Development (R&D) method with a dynamics system approach in Makassar City. The sample in this study is data on dengue cases in Makassar City from 2012 to 2016. The right policy scenario in reducing dengue cases is carried out using Interpretative Structural Modeling (ISM). The PowerSim program is used to analyze the dynamic model of DHF incidence. Results: The results showed that the critical elements of DHF prevention were jumantik, 3M Plus, early warning systems, and counseling. Based on a dynamic model simulation for 20 years in Makassar City by applying the jumantik scenario, 3M Plus, early warning systems, counseling, and the combined procedure, the estimated average dengue incidence has decreased by 2.3%, 27.7%, 52.2%, 11.71, respectively. % and 95.7%. Conclusion: The incidence of dengue fever in Makassar City can be controlled by combining the jumantik program, 3M Plus, early warning systems, and counseling.