Objective: To understand the cognition, attitude and satisfaction on the National Essential Medicines System among Community Health Service Centers (CHSC) and Township Health Centers (THC) in Hefei, and its influencing factors. Methods: A self-designed questionnaire survey was conducted among 664 outpatients randomly selected from CHSC and THC in Hefei. Chi-square test and logistic regression were used for data analysis. Results: 45.6% outpatients expressed their completely incomprehension in National Essential Medicine System. The comprehensive satisfaction degree was 74.1%, the satisfaction score was 71.24 and there were statistically significant differences in the satisfaction scores among different types of insurance. Conclusion: The awareness rate and the comprehensive satisfaction degree of outpatients on National Essential Medicine System were low. It is suggested that we should strengthening publicity and training of the system actively, improving the bidding system of essential medicines, and speeding up the integration of urban and rural residents’ medical insurance.