Abstract: Objective To investigate the situation of free premarital examination and its influencing factors in districts of Zhangye city,Gansu province and to provide a reference for improving the efficiency of premarital examination. Methods The data on free premarital examination in districts and counties of Zhangye city from September 2008 through October 2009 were collected and analyzed. Results One year after the implementation of free premarital examination,a total of 17 406 people took the examination with a premarital examination rate of of 93.67% and 3 873 cases of abnormalities were detected.The disease detection rates of different abnormalities from high to low were reproductive system disease (12.10%),infectious disease(6.23%),internal or surgical disease(3.49%),other kinds of disease(0.30%),hereditary disease(0.13%),sexually transmitted disease(0.06%),and mental illness(0.01%),respectively.There were 89.97% of the examinees with abnormalities detected were allowed to get married and 10.03% of the examinees got guidance for the abnormalities from medical staff. Conclusion After the introduction of free premarital examination,the number of people takting the check-up increased dramatically,but there were still some people unwilling to accept the premarital examination. It is necessary to further promote the free premarital examination.The results suggest that infectious disease and reproductive system disease are the the key points for health education among young couples to be married.