Public hospital reform in our country began since 2009. Each provinces and cities did actively explorations in areas for city and county public hospitals reform， such as major system and mechanism reform， service system construction， the measures for convenience and affordability of patients， motivating the enthusiasm of medical staff and so on. In general， the reform has made some progress. But there were still some problems and confusion in the reform. Unclear top design system and mechanism reform， unobvious effect on medical expense control and lack of power of hospital reform posed challenges for public hospital reform. The next step of public hospital reform will be taken from the top design， strengthen government health investment and compensation， deepening reform of the personnel salary， arousing the enthusiasm of the medical staff to seek breakthrough.