Objective To analyze the reasons for the return of unqualified Chinese medicine pieces in our hospital and take corresponding improved measures to ensure the safety of clinical medication.Methods A total of 197 batches of Chinese medicine pieces returned from 2016 to 2019 in our hospital were selected as the research objects.Based on the return records, Excel software was used to analyze the reasons for the return.Results The main reasons for the return were fakes and adulteration (9.1%), dyeing (3.0%), weight gain (10.2%), extraction of drug residue (1.0%), fumigation with sulfur (15.2%), oil brimming (12.2%), unqualified processing (27.9%), mixed use of local standard varieties(6.1%), mixed use of national pharmacopoeia standard varieties (7.1%), and others (8.1%).There were 12 tenders in total from 2016 to 2019 with 1591 batches, and 197 batches were returned accounting for 12.4%.Conclusion The reasons for the return of unqualified Chinese medicine pieces in our hospital mainly include unqualified processing, fumigation with sulfur, oil brimming, etc.Based on the above-mentioned main reasons for return, our hospital has put forward four improved measures and strictly implemented them, which has greatly improved the quality of Chinese medicine pieces in our hospital.