OBJECTIVE： To investigate the implementation and problems of the “two-invoice system” in medical institutions of Yunnan province and provide reference for policy adjustment and optimization. METHODS： The questionnaire was designed based on national and Yunnan province’s policy and literature research of “two-invoice system”. The questionnaire survey was conducted during Jan.-Feb. 2018 among Yunnan provincial public hospitals where the policy of “two-invoice system” was implemented firstly and third-level public hospitals in the pilot cities of public hospital reform in some prefectures. Drug purchasing managers of the interviewed medical institutions filled out the questionnaire which covered the basic situation of the interviewed medical institutions， the implementation of the “two-invoice system” policy， the impact of the “two-invoice system” policy， other issues and suggestions. The problems existing in the implementation of the “two-invoice system” policy in medical institutions were analyzed and countermeasures were put forward. RESULTS & CONCLUSIONS： A total of 39 medical institutions were interviewed， and 39 questionnaires were distributed. 39 valid questionnaires were obtained， with an effective rate of 100％. The interviewed medical institutions had implemented the “two-invoice system” policy. During the implementation of the system， medical institutions have insufficient compliance and legality in ticket inspection work，and the pressure on policy implementation is relatively high. The impact of the “two-invoice system” on reducing drug prices is not significant. Some clinically necessary drugs are unable to implement the “two-invoice system” temporarily，which has aggravated the shortage of drugs. Based on the above problems， it is recommended to improve the supervision of the bills， establish a unified “third party” ticket inspection platform to ensure the standardization of the ticket inspection work； continue to pay attention to the impact of the “two-invoice system” on drugs price， and do a good job of supervision and verification of manufacturers； solve the problem that some drugs cannot implement the “two-invoice system” properly so as to further promote and optimize the implementation of the “two-invoice system” policy.