Objective: The coverage and profit and loss of a tertiary general hospital under Diagnosis Related Group(DRG) were analyzed, and constructive management strategies were put forward. Methods: Descriptive statistical analysis was used to compare and analyze the structure of main profit and loss groups under DRG operation. Results: A total of 22 MDCS were covered in the target hospitals, and the number of DRG groups was 485 . The FM3B group suffered the most serious loss. Conclusion: Under the DRG payment reform, the structure of diseases should be optimized, medical costs should be controlled reasonably, and medical service efficiency should be improved.