Abstract: Objective To explore the accessibility of anti-hypertensive drugs in different primary medical institutions in China and the related factors affecting drug usage. Methods From June 4 to August 5 2019, a total of 4 062 Chinese clinicians participated in the survey. According to the "2017 national basic medical insurance directory", 8 categories and 70 kinds of oral antihypertensive drugs were used as the investigated drugs in this study. Availability rate in WHO/HAI（World Health Organization/Health Action International） standard survey method was used as the evaluation indicator of accessibility. Questionnaire was developed using the Delphi method, and data were collected through mobile WeChat link mode. Furtherly, the accessibilities of anti-hypertensive drugs were compared and analyzed in township and urban primary medical institutions. At the same time, logistic regression analysis was carried out with the use/no-use of available drugs as the dependent variable, and the working years, professional titles, cities/towns and regions as independent variables. Results（1）In all primary medical institutions, the drugs with highest overall accessibility（availability rate＞75%） included compound reserpine and amitripterine（88.4%） and nifedipine（76.9%）. The drugs with higher overall accessibility（availability rate 50%-75%） included indapamide（65.3%）, metoprolol（61.6%）, amlodipine（57.4%）, captopril（55.9%）, valsartan（53.9%）, compound reserpine（compound antihypertensive tablets）（53.2%）, enalapril（52.6%）, hydrochlorothiazide（51.3%） and irbesartan（50.5%）.（2）Compound reserpine and amitripterine, nitrendipine, dibazol, naftopidil, hydralazine and minoxidil in township primary medical institutions were statistically higher than that in urban primary medical institutions.（3）In five kinds of antihypertensive and diuretic compound, diuretics, β-blockers, calcium channel blockers and angiotensin converting enzyme inhibitor/angiotensin receptor blocker（ACEI/ARB）, the most available durgs was compound reserpine and amitripterine, indapamide, metoprolol, nifedipine and captopril respectively. Logistic regression analysis showed that the use/no-use of these drugs was related to working years and professional titles of doctors, primary medical institutions in towns/cities and areas. Conclusions The accessibility of compound reserpine and amitripterine, and nifedipine in primary medical institutions in China was high. The availability rate of most anti-hypertensive drugs in urban primary medical institutions was higher than that in township primary medical institutions. The working years and professional titles of doctors, the township/city primary medical institutions and the areas where they were located were related to the use of compound reserpine and amitripterine, indapamide, metoprolol, nifedipine and captopril after they were available.