Objective To explore the trends in change and characteristics of medical income structure in Shanghai in recent years, find out the main items that affect the medical income structure change, optimize the medical income structure , find out the reasons for the unreasonable growth of medical expenses and provide theoretical support for effective control of medical expenses .Methods Collecting medical income date of Shanghai from 2012 to 2015 and using the index of structural change value, Degree of Structure Variation and structural contribution rate to analyze. Results The Degree of Structure Variation of medical income was 7.88% from 2012 to 2015, the income of western medicine, Chinese medicine, herbal medicine, assay and treatment are the main items that caused the Changes in Outpatient income structure . The Degree of Structure Variation of Hospitalization income was 13.64% from 2012 to 2015, health material income, Western medicine income, Chinese medicine income, surgical income, laboratory income are the main items that effect medical income. Conclusion The income of pharmaceuticals and health materials is the main item influencing the medical income. The proportion of inspection laboratory income is relatively high and labor service income is relatively low. The management department should further strengthen the supervision of pharmaceuticals and medical materials , improve the labor service income of medical personnel and further Strengthen the optimization of medical income structure