Objective: To understand the cost composition and management status of fixed assets in public hospitals，explore the problems in the cost management of fixed assets，and use the thinking and methods of management accounting to put forward countermeasures and suggestions to improve the cost management of fixed assets in public hospitals. Methods: Using the method of random sampling113 public hospitals were selected as the object of the questionnaire survey，and the self-designed questionnaire was used to investigate the current situation and main problems of fixed asset cost management. The current policy requirements and research progress of fixed asset cost management in public hospitals were summarized through literature research. Descriptive statistical analysis was carried out on the recovered data. Results: 52 hospitals (46.02%) self-evaluated that their fixed asset cost management was at a good level，and 76.99 %of the hospitals believed that the cost composition of fixed assets should include acquisition cost，maintenance cost，disposal cost and use cost. The top three major problems in the cost management of fixed assets were the weak awareness of cost management in hospitals (67.26 %)，the low level of informatization (65.49 %) and the insufficient attention to the cost management of fixed assets (62.83 %). Only 9.30 %of the sample hospitals have better applied management accounting thinking in the cost management of fixed assets. Conclusion: It needed to further establish and improve the cost management system of fixed assets，establish the responsibility system of the cost management of the whole life cycle of fixed assets，use the thinking and methods of management accounting，optimize the cost management of fixed assets，integrate the data of information management system，provide support for the cost management of fixed assets，and improve the cost management awareness of all staff by strengthening publicity and training.