Through operation analysis of the department of thyroid and breast surgery in a tertiary general hospital under the new situation of medical reform， this study is to discuss the fine management of hospitals. To investigate and analyze the operation status of the department of thyroid and breast surgery in a tertiary general hospital， including workload， operation efficiency， profit and loss situation， etc. The results showed that there were many outpatients， inpatients and ultrasound examination patients in the department of thyroid and breast surgery， and the physicians had a heavy workload. It was calculated that two clerks were needed to be added in this department； through the profit and loss analysis， it showed that the department of thyroid and breast surgery is a taurus department， and the utilization rate of the bed is high. The scale should be appropriately expanded to additional 10 beds. Through detailed operational analysis of all departments of the hospital， decision?making basis can be provided for hospital administrators and managers and the fine management of the hospital will be realized gradually.