By analyzing the root causes of hospital fraud, it discusses the characteristics and difficulties of hospital fraud audit, and tries to construct a theoretical framework of hospital fraud audit. It puts forward strategies of fraud audit in hospitals from aspects of improving the competence of internal auditors, giving full play to the role of internal control in resisting fraud risk, finding fraud performance through fraud signs, strengthening the audit psychological game with the audited object, perfecting and improving the procedures and methods of fraud audit and creating a cultural atmosphere to prevent fraud, so as to provide guidance for the launch of fraud audit in public hospitals.