Abstract: Objective To evaluate the efficiency of county-level public hospitals in Guangxi and to analyze operation problems of the hospitals for policy-making in general public hospitals reform at county level.Methods Data envelopment analysis(DEA) was adopted in the evaluation.Results For the 75 county level general public hospitals in Guangxi, 21(28%) were overall effective.The average score for overall efficiency was 0.916, indicating the overall efficiency of county level public hospitals was low.There were 39(52%) hospitals with technical efficiency, 18(24%) with technology efficiency rather than scale efficiency, and 22(29.33%) with scale efficiency.For the 53 non-scale efficient hospitals, 17(22.67%) had increasing scale efficiency and 36(48%) had decreasing scale efficiency.Conclusion There still is resource waste in county level public general hospitals in Guangxi, indicating the hospital management needs to be improved.