OBJECTIVES: Essential Medicine policy is a important component of China's undergoing healthcare  reform,while the essential medicine list(the ”EML”) is the core of the essential medicine policy. On August 18, 2009, China issued national essential medicine list (the ”NEML”,1st edition) with 205 western medicines and 102 traditional Chinese medicines(the ”TCM”) in it, and each province can add further medicines to the NEML to form its own provincial essential medicine list(the ”PEML”) under specific circumstances. This paper aims at supporting for the next round adjustment of the NEML through analyzing the situation of addition to the NEML by each province. METHODS: To study the addition to the NEML by each province, this paper analyzes the number of medicines added to NEML in all 31 provincial regions in china during the period of August 18, 2009 to January 1, 2011 through searching the official websites , spot investigation and interview the officials. RESULTS: (1)So far there are 18 provincial regions having added further medicines to the EML; (2) Regardless of folk medicine, the average number of essential medicines added in each province is 187,among which western medicines added 115 while the TCM added 72.(3) Shanghai added the largest number of medicines to its PEML, i.e. 381,while Qinghai Province added the smallest number of 60.(4)Some autonomous regions added folk medicines to the PEML according to the local conditions.CONCLUSIONS: (1)it’s necessary for China to adjust the NEML(1st edition) reasonably based on the number of medicines added to the PEML and drug using characteristics in each province;(2)The more developed the economy, the more the further essential medicines added, which leads to unfair and lower the accessiblity to essential medicines in poor areas, thus the government should increase investment in poor areas.