OBJECTIVES: By estimating the direct medical cost of malignant neoplasms inpatients with urban basic health insurance scheme(UBHIS) in 2011 in China, we try to provide evidence for the government to manage the illness more effectively. METHODS: A nationwide, cross-sectional sampling of malignant neoplasms inpatients with UBHIS was extracted from the China Health Insurance Research Association claim database. A retrospective analysis was adopted and all results were extrapolated to the whole country according to the scale of the population, economics and other factors in the sample cities. RESULTS: The visits of malignant neoplasms inpatients, accounted for 7.64% of total visits, were 2.92 million. The rank of main malignant neoplasms inpatients  were lung cancer, breast cancer, gastric cancer, rectum cancer, colon cancer and liver cancer, which accounted for 54.09% in all malignant neoplasms inpatients. The  hospitalization expenses of malignant neoplasms inpatients was 42.61 billion yuan, as the top costs, which accounted for 13.59% in all hospitalization expenses; the proportion of the above six kinds of cancer costs was 52.00% (22.16 billion yuan) in all hospitalization expenses of malignant neoplasms inpatients. The average hospitalization expenses of each visit was 14,594 yuan (14,513 yuan in 2010), the average hospitalization expenses of  every day was 914 yuan (increasing by 8.7% from 2010). The composition of hospitalization expenses: drugs 53.85%, diagnosis and treatments 39.00%, medical consumables 7.15%. Reimbursement by UBHIS was 69.34% (66.44% in 2010), about 29.55 billion yuan. CONCLUSIONS: Cancer brought large disease burden in China, particularly, six kinds of cancer mentioned above have much hospitalization expenses. The reimbursement by UBHIS added 3% from 2010 to 2011, reducing the economic burden of malignant neoplasms inpatients. However, for the poor, the personal burden is still a problem. China has launched supplemental insurance for catastrophic health expenditure, relieving the burden of disease constantly.