OBJECTIVE： To investigate the status quo of drug use of outpatient prescriptions in primary medical institutions in a city of Hubei province based on the background of the implementation of Essential Medicine System， and to provide reference for rational drug use in primary medical institutions. METHODS： A random number table method was used to select outpatient prescriptions from hospital information system of 6 primary medical institutions （2 community health service centers and 4 township health centers） in a city of Hubei province during Jan. 2014-Dec. 2016. The situation of drug use was analyzed by using prescription index system jointly developed by WHO and INRUD. RESULTS： In 2014-2016， the average number of drugs in each prescription was decreased significantly in community health service centers and township health centers. There were 2.67， 2.57 and 2.33 species/pieces in community health service centers， and 5.05， 4.84 and 3.59 species/pieces in township health centers. The drug cost of each prescription were decreased in community health service centers year by year， being 57.54， 55.27 and 36.36 yuan/piece； those of township health centers were increased year by year， being 36.80， 37.87 and 52.13 yuan/piece， respectively. The proportions of prescription essential medicine were 94.44％， 90.32％， 97.22％ in community health service centers； those of township health centers were 89.40％， 91.25％， 97.22％， which were all close to the standard recommended by WHO. The proportions of antibiotics prescription were 49.42％， 47.58％ and 45.46％ in community health service centers； those of township health centers were 41.90％， 39.77％ and 43.46％， which were all higher than the standard recommended by WHO. The proportions of hormone prescription were 6.38％， 5.75％ and 5.17％ in community health service centers， which were within the standard recommended by WHO； those of township health centers were 12.71％， 9.90％ and 9.46％， which would tend to the standard recommended by WHO. In addition， top 5 drugs were all antibacterial drugs in primary medical institutions. CONCLUSIONS： The outpatient prescriptions are reasonable in 6 primary medical institutions of a city in Hubei province. However， there still is excessive use of antibacterial drugs； township health centers need further supervision and management in particularly.