Objective To understand the current situation of medical waste management in primary medical institutions in Wuhan, find out the problems and put forward improvement countermeasures. Methods In July 2018, a stratified sampling method was used to investigate the medical waste management of 45 medical institutions in 13 districts of Wuhan. Results In 2017, the median of production of medical waste generated by 45 medical institutions was 0.32 kg/bed-day, the median of medical waste disposal fee was 0.67 yuan/bed-day, the rational disposal rate of uncontaminated disposable infusion bottles after use was 64.44%. 93.33% of medical institutions had leading groups for medical waste management, only 57.78% of medical institutions identified administrative department of medical waste management, the correct rate of medical waste classification was 60.00%. 97.78% of medical institutions established the temporary storage facilities and equipment for medical waste, and equipping rate of complete protective equipment was 73.33%, equipping rate of complete hand washing facilities and hand hygiene products was 64.44%. All medical institutions put medical waste to centralized medical waste disposal center, only 35.56% of medical institutions could transfer medical waste within 2 days. The qualified rates of medical waste temporary storage time and administrative department defining for medical waste management in secondary medical institutions is higher than primary medical institutions(both P<0.05), there were no significant difference in the other indexes. Conclusion Medical waste management in primary medical institutions of Wuhan has been gradually standardized, but there are still problems, especially the temporary storage time of medical waste in primary medical institutions >2 days. It is necessary to increase communication and cooperation in multiple departments, strengthen training and supervision, and explore an appropriate management mode.