Abstract: Objective: Discussion on the improvement of the internal control of the budget management in public hospitals. Methods: Analyzing problems and reasons based on COSO and exploring path of operation procedure based on BSC of the system building of budget management in public hospital. Results: Internal control influences the quality of budget management directly. Conclusion: Reinforcing the building of control environment of budget management in public hospital, strengthening the risk awareness of financial management, building the system of budget management based on the principal of separating the incompatible duties in combination with BSC