Objective  To examine the satisfaction with the healthy city construction and factors influencing the satisfaction among community residents in Hangzhou city, Zhejiang province and to provide evidences for the development of activities related to the construction of a healthy city in the region.

  Methods  Using stratified random sampling, we conducted a self-administered questionnaire among 5 850 permanent residents aged 15 – 75 years from 30 communities/towns of 3 districts/counties in Hangzhou city, Zhejiang province from November 2019 through July 2020.

  Results  Of the 5 559 participants with valid responses, 75.5% expressed general satisfaction with the healthy city construction in Hangzhou city; the proportions of the participants expressed satisfaction with the components of healthy city construction were 80.8% for quality of medical and health care services, 82.8% for social security, 69.8% for surface water sanitation, 66.9% for air quality, 73.8% for domestic waste sorting collection and treatment, 78.6% for road environmental sanitation, 79.0% for greenland coverage, 69.2% for food safety, 87.6% for local social security, 70.9% for employment opportunities and environment, 71.8% for education resource equity, 82.6% for public transportation convenience, 72.9% for fitness venues and facility construction, 71.4% for cultural venues construction, and 74.2% for health promotion in public media, respectively. The results of multivariate logistic regression analysis showed that the participants with following characteristics were more likely to have a lower satisfaction with healthy city construction: with the education of junior high school and above, being enterprise workers/students/freelances/retirees/the unemployed/farmers or other personnel, and with registered rural residence; while, the participants with a monthly household income of ≥ 2 001 Yuan RMB, being aware of healthy city construction activities, and participating in healthy city construction activities were more likely to have a higher satisfaction with the healthy city construction.

  Conclusion  Among 15 – 75 years old residents in Hangzhou city, the satisfaction with healthy city construction is relatively low and the satisfaction is mainly influenced by education, occupation, household registration, monthly household income per capita, whether being aware o healthy city construction, and participating in healthy city construction activities.