Objective To investigate the application of mercury sphygmomanometers and thermometers and their corresponding substitutes in 212 medical institutions (MIs) in Shaanxi Province from 2017 to 2020, and provide suggestions on the substitutes of mercury-containing products in medical and health industry in Shaanxi Province based on the implementation status of Minamata Convention. Methods Hospitals as well as primary medical and health institutions in Shaanxi Province were selected by stratified random sampling. Application of mercury sphygmomanometers, thermometers and corresponding substitutes in MIs of different levels from 2017 to 2020 were investigated. Results A total of 212 MIs in Shaanxi Province were investigated, including 57 hospitals and 155 primary medical and health institutions. From 2017 to 2020, mercury sphygmomanometers usage amount per bed in MIs were 0.073, 0.068, 0.066 and 0.059 pieces respectively. 2020 was lower than other years. Usage amount per bed in primary MIs was higher than hospitals, with statistical difference (all P < 0.05). Mercury thermometers usa-ge amount per bed each year were 2.185, 2.121, 1.916 and 2.631 pieces respectively, 2019 was lower than 2017, with statistical difference (P=0.027). Mercury-free sphygmomanometers usage amount per bed each year were 0.014, 0.015, 0.028, and 0.038 pieces, 176, 325, 468 and 511 pieces were purchased, respectively. In 2019 and 2020, mercury-free sphygmomanometers usage amount per bed in hospitals was higher than that in primary MIs, with statistical difference (P < 0.05). Mercury-free thermometer usage amount per bed were 0.010, 0.011, 0.013, and 0.028 pieces, 173, 221, 227 and 684 pieces were purchased respectively. Mercury-free thermometer usage amount per bed in hospitals was higher than that in primary MIs, with statistical difference (P < 0.05). In the survey on temporary storage of mercury-containing waste, 50.88% hospitals and 46.45% primary medical and health institutions mixed mercury-containing waste with other medical waste for direct disposal. In the survey on the disposal methods of mercury-containing waste, 19.30% hospitals and 16.77% primary medical and health institutions disposed mercury-containing waste by themselves (landfill, stockpiling and recycling). Conclusion Usage of mercury sphygmomanometers and thermometers in MIs in Shaanxi Province has been decreasing year by year, and usage of corresponding substitutes has been increasing. The provincial MIs are actively implementing the Minamata Convention, fulfillment effect appears initially.