Abstract: The operational efficiency of public traditional Chinese medicine (TCM) medical institutions in 30 provinces (municipalities and autonomous regions) in China in 2019 was analyzed through a three-stage data envelopment model. The results showed that the operational efficiency of medical institutions in various regions of China was uneven, and environmental factors had a significant impact on the efficiency. The operational efficiency of most provinces and cities was in the state of increasing returns to scale. Therefore, we should attach importance to the allocation of TCM resources, improve the scale efficiency, strengthen health supervision, optimize resource allocation, realize medical connectivity and strengthen regional cooperation.