OBJECTIVE：To provide reference for improving the national essential medicine system. METHODS： Based on the PEST model， the factors of model were appropriately adjusted combining the research object， and a new PEST model was established for the national essential medicine distribution environment to further analyze the political environment， economic environment， social environment and technical environment for the essential medicine distribution. RESULTS & CONCLUSIONS： The study shows the distribution environment of the essential medicine has its advantages and disadvantages， perplexing and interaction. Improving the essential medicine system should put emphasis on straightening out the various supporting policies and measures， establish the fair， open and scientific selection and methods， increase the financial compensation on the R&D， manufacturing， management， and using in medical and health institutions and social drugstores， strengthen the training in the basic medical institution， enhance the publicity and improve the social recognition for the national essential medicine system.