Abstract: Objective To evaluate the diagnosis and reporting of communicable diseases in the basic medical institutions in the mainland of China and provide evidence to improve their capacities for public health service. Methods Analysis was conducted on the reporting data of communicable diseases by basic medical institutions in China in 2012 with SAS 9.2 software. Related statistical tables and figures were made by using Microsoft Excel 2007 and statistical maps were made with software Arc GIS 9.3. Results In 2012, there were 41 865 basic medical institutes in China, accounting for 62% of total medical institutions included in network direct reporting system. The nationwide network direct reporting rate was 92%. The network direct reporting rate was lowest in western region. A total of 745 407 cases of communicable diseases were reported by basic medical institutions in 2012, accounting for 11% of the national total. No diseases in class A or other highly infectious diseases included in class A were reported. Most diseases diagnosed and reported were in class C, accounting for 63% of the total. The differences in diseases diagnosed and reported among the basic medical institutions in eastern, central and western regions had no statistical significance. In basic medical institutions, the laboratory confirmation rate of reported cases was about 22%, lower than that in county level and above hospitals, the timely reporting rate of the diseases was 98%, higher than that in county level and above hospitals, but the timely reporting rate of smear positive and bacteriological negative pulmonary tuberculosis was low. Conclusion There are a large number of basic medical institutions in China, but their capacities of disease clinical diagnosis and laboratory confirmation are limited. It is necessary to increase the investment for basic medical institutions and conduct training on communicable disease diagnosis and reporting among their staff, particularly in western region.