Abstract: Objective To investigate the recognition of occupational health surveillance of workers in small and medium-sized industry enterprises (SMEs) for the improvement of occupational health.Methods The data were collected from a questionnaire survey in 1 380 workers exposed to occupational hazard in 50 SMEs selected with multistage sampling from two cities of Hubei province.Results Totally 85.1% of the workers knew that enterprises should provide occupational health examination for workers exposed to occupational hazard and 79.3% of the workers knew that the expense of occupational health examination should be paid by the enterprises.But only 57.0% of the workers knew that enterprises should keep the records of occupational health surveillance for workers exposed to occupational hazard.Newspapers and magazines,publicity boards in enterprises,and the internet were the most important ways that the workers acquired the knowledge of occupational health surveillance.Multiple linear regression analyses showed that the positive factors affecting occupational health surveillance knowledge level were with work-related injury insurance,higher monthly income,working in medium-sized enterprise,being member of labor union,male,and higher educational level,while the negative factor was with older age.There was a positive correlation between willingness score and knowledge score about occupational health surveillance (r=0.442,P<0.05).Conclusion The workers in SMEs had a certain level of occupational health surveillance knowledge but the propagation and popularization of the knowledge should be enhanced according to the specific situation,with the purpose of promoting a positive attitude and faith toward occupational health surveillance among workers in SMEs.