ObjectiveTo monitor hand hygiene(HH) compliance of health care workers(HCWs) with a new method, compare the advantage and disadvantage with direct observation method.MethodsFrom July to December 2016, HH compliance of HCWs in intensive care unit (ICU) of a tertiary hospital was monitored simultaneously by HH electronic monitoring system and traditional direct observation method, results of two monitoring methods were compared. ResultsICU was observed for 7 days (42 hours), 2 231 HH opportunities were recorded, a total of 4 532 HH opportunities in 7 days were estimated, total bedday was 23 days, the average HH opportunities required for HCWs in ICU was 197 times/bedday. From July to December 2016, HH compliance rate monitored by electronic monitoring system was 54.16% on average, which was lower than 77.72% of direct observation method （χ2=50.53，P<0.001）. Cost of HH electronic monitoring system per hour (4.56 Yuan) was lower than that of direct observation method (20.78 Yuan).ConclusionCompared with traditional direct observation method, HH electronic monitoring system is more timesaving and laborsaving, data are more accurate and objective, and has a certain cost advantage in the economically developed regions.