Abstract: Objective The present study was conducted to assess the management performance of infectious disease direct reporting network in Chinas medical institutions at all levels, and to uncover the existing problems thereof, providing the basis for development of the next generation of quality control strategies. Methods Eighty-four medical institutions were investigated nationwide using the stratified sampling method. Results A total of 1634 out-patient and hospitalized valid cases of infectious disease as well as 802 report cards were collected. The average omission rate was 12.67% among the medical institutions throughout the country, the one of hospitalized cases higher than that of out-patients. The compliance rate of out-patient daily registration was 96.22%, the registry integrity rate was 96.86%, and the timely report rate of medical institutions 90.98%. The completion rate of infectious disease report cards was 90.27%, with an accuracy rate of 75.29%. The consistency rate between paper report cards and network reporting was 72.32%. Township-level medical institutions demonstrated a higher overall report quality than those at county-level and above. Conclusion Despite significant achievements of the infectious disease reporting management under the current direct reporting network system, several loopholes need to be plugged such as those in the accuracy of individual cases.