Objective: To understand and analyze the bed utilization efficiency of county level Traditional Chinese Medicine (TCM) hospitals in China, so as to provide references for the rational allocation of bed resources in TCM hospitals. Methods: The rank sum ratio method and the bed utilization model were used to analyze the bed utilization efficiency of county level TCM hospitals in China with different bed sizes in 2019. Results: The results of rank sum ratio method showed that the county level TCM hospitals with a size of 500-799 beds were located in the top class, while the rest of the beds were located in the middle class. The results of the bed utilization model show that county-level TCM hospitals with a size of less than 300 beds are of the idle type, with a size of 800-999 beds being of the press type, and with a size of 300-499, 500-799, and 1000-1500 beds being of the bed efficiency type. Conclusion: (1) The overall bed utilization efficiency of county level TCM hospitals needs to be improved. (2) The utilization efficien- cy of 300-499 beds in county level TCM hospitals is good, which is conducive to expanding the service functions of the county-level Chinese medicine medical system. (3) The utilization efficiency of beds in county-level TCM hospitals with fewer than 300 beds is relatively low, which urgently requires greater attention from governments.