ObjectiveTo understand the current situation of pressure steam sterilization in medical institutions in Xi’an city, and provide reference for the monitoring and quality control of pressure steam sterilization. MethodsCentral sterile supply departments（CSSDs） in medical institutions in Xi’an in 2012-2014 were investigated. Physical, chemical, and biological monitoring methods were used to evaluate the pressure steam sterilizers. ResultsA total of 135 medical institutions in Xi’an were monitored, including 40 tertiary medical institutions and 95 secondary and below medical institutions. A total of 540 specimens were collected, 454 were qualified, overall qualified rate was 84.07%. Qualified rate of monitoring result of pressure steam sterilization of tertiary medical institutions was higher than secondary and below medical institutions（93.13% vs 80.26%, χ2=13.91，P＜0.01）. Qualified rates of chemical PCD and biological test pack of tertiary as well as secondary and below medical institutions were 100% and ＞90% respectively. The qualified rate of  recoded temperature in secondary and below medical institutions was 88.42%, but actually measured temperature was 38.95%，which was significantly lower than 72.50% of tertiary medical institutions（χ2=12.68，P＜0.01）. The rates of the measured temperature>134℃ of pressure steam sterilizer in each year were all low, but measured temperature＜132℃ was about 50.00%, difference between actually measured temperature and recorded temperature was -4℃-1℃，difference between -2.5℃-0.5℃ accounted for 80.00%，the main unqualified temperature was 130℃-131℃，accounting for 82.61%. ConclusionEfficacy of pressure steam sterilization is different in different levels of medical institutions in Xi’an, physical monitoring measures are not standardized, the supervision of physical parameters in key sectors should be strengthened to ensure the sterilization quality of medical institutions and reduce the occurrence of iatrogenic infection.