OBJECTIVE： To provide reference for clinical rational drug use. METHODS： The drug sales amount， DDDs， DDC and major pharmaceutical enterprises in 273 sample hospitals of Yangtze River basin in 2014 were statistically analyzed.  RESULTS： The growth of consumption sum slowed down gradually. The anti-infective drugs， cardiovascular drugs and nervous system drugs occupied the medical mainstream market. Top 3 drugs in the list of consumption sum in consecutive 4 quarters were monosialotetrahexosylganglioside， thymic peptide and lansoprazole. Nearly half of top 15 drugs were auxiliary drugs； Chinese patent medicines grew increasingly and appeared in the list. The sales enterprises were mainly domestic enterprises， which concentrated in Sichuan， Chongqing， Jiangsu province， and other places. CONCLUSIONS： The structure of drug use in sample hospitals is basically consistent with the spectrum of disease in China. However， there is deviation between auxiliary drug use and international guide， and the rationality of clinical drug use needs to be improved.