Background: Clinical guidelines are known as an effective way to improve health performance. However, little is known about general practitioners’ attitudes to and behaviours concerning clinical guidelines in China.

Objectives: The aim of this study is to investigate use behaviours and needs of clinical guideline in primary care of China.

Methods: We conducted a cross-sectional survey among 268 institutions in 15 provinces of China from December 2015 to May 2016. The questionnaire was developed by literature review and experts consultation method. On-site survey was performed by paper questionnaires to minimise response missing. Multivariate logistic regression was used to identify factors associated with the knowledge of and attitude towards clinical guidelines.

Results: Among respondents, 91.7%(1568/1708) knew clinical guidelines but only 11.3%(177/1568) frequently use them. The main access to guidelines for primary-care practitioners was public search engines (63.4%;911/1438) instead of biomedical database and the major barriers for primary-care practitioners to use guidelines included lack of training (49.9%;778/1560), access (44.6%;696/1560) and awareness (38.0%;592/1560). Only less than ¼ of respondents considered current guidelines were ‘entirely appropriate’ for primary-care setting (23.5%;339/1442). Most participants (96.2%;1509/1568) admitted the necessity of developing clinical guidelines for primary care. The attitude towards current guideline was associated with institutions’ location, level, and professional title (P