Abstract: Objective To examine the accordance rate of diagnosis for hepatitis B (HB),hepatitis C (HC),pulmonary tuberculosis (TB),and syphilis (SYP) in medical institutions in Guangxi Zhuang Autonomous Region (Guangxi) and to provide evidences for promoting infectious surveillance and report quality in the region.Methods Medical records of 1 044 HB,HC,TB,and SYP patients hospitalized during 2014 were extracted from 21 general hospitals (7 at municipal and 14 at county level) in Guangxi by using stratified random sampling and the accordance rate for the diagnosis of the inpatients were analyzed in August 2015.Results The overall diagnostic accordance rate for the four infectious diseases made by the 21 hospitals was 60.82% (635/1 044);the diagnostic accordance rate of municipal-level hospitals was significantly higher than that of county-hospitals (68.86%283/411vs.55.61%352/633)(P<0.001).The diagnostic accordance rate was 61.89% (164/265) for HB,37.40%(98/262)for HC,83.71%(221/264) for TB,and 60.08% (152/253) for SYP,respectively,with significant difference (χ²=118.53, P<0.001).Of the 409 inconsistent diagnoses,96 (23.47%) were misdiagnosis;174 (42.54%) were misclassification;133 (32.52%) were wrong types;and 6 (1.47%) were over-diagnosis.Conclusion The diagnostic coincidence rate of hepatitis B,hepatitis C,pulmonary tuberculosis,and syphilis is relatively low in Guangxi and the accordance rate of diagnosis for the four infectious disease for municipal-level general hospitals is higher than that of county-level general hospitals.