ObjectiveTo summarize the effectiveness in monitoring activities for healthcareassociated infection (HAI) in China in the past 30 years, explore the changing trend in HAI monitoring, find a new model for the monitoring of HAI in China. MethodsA total of 194 comprehensive hospitals and military hospitals in 13 provinces (autonomous regions, municipalities) were selected, questionnaire survey was adopted to investigate the situation of HAI monitoring. ResultsOf 194 hospitals, 184 (94.85%) had available data after being checked, incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively， difference was significant (P＜0.01）. Monitoring was divided into two stages, cumulative percentage of each monitoring activity before 2006 and during 20062016 were respectively as follows: environmental hygiene were 73.91% and 100.00%, disinfection efficacy 69.57% and 97.28%, overall comprehensive monitoring  64.67% and 98.91%, surgical site infection(SSI) 13.04% and 94.57%, ICU HAI  4.89% and 87.50%, neonatal HAI 1.75% and 60.82%, multidrugresistant organisms(MDROs) 5.43% and 95.65%, hand hygiene compliance  2.17% and 93.48%, antimicrobial agents 15.22% and 87.50%. The reporting rate of HAI  outbreak in tertiary hospitals was higher than secondary hospitals ( 33.33% ［n=37］ vs 16.44%［n=12］, P=0.01）. ConclusionThe monitoring of HAI in China starts late, but develops rapidly, defects still exist in HAI monitoring system, reporting rate of HAI cases is still high, reporting rate of HAI outbreak is low.