Abstract: OBJECTIVE To understand the current status of regionalized sterilization and supply services in hospitals of Shanghai so as to provide bases for continuous improvement of sterilization and supply service. METHODS By means of purposive sampling, a questionnaire survey was conducted for the hospitals where the entrusting or contracted management mode for sterilization and supply services was adopted in Nov. 2025 and the results were statistically described. RESULTS Among the 33 entrusting hospitals, 17 (51.52%) reported that the processing cycle of routine instruments exceeded 12 hours. The establishment rate of on-site emergency supply centers was 91.67% (22/24) in secondary and tertiary hospitals, significantly higher than 33.33% (3/9) in community health service centers and private medical institutions (rate difference = 58.34%, 95%CI: 24.63% to 82.14%, P= 0.001). 10 (41.67%) entrusting secondary and tertiary hospitals processed delicate surgical instruments independently. The rates of compliance with standardized procedures during the recycle phase ranged from 39.39% to 72.73% in the entrusting hospitals. 12 (36.36%) entrusting hospitals conducted daily quality spot checks, 69.23% of which were tertiary hospitals, 18.18% were secondary hospitals, and 11.11% were community health service centers and private hospitals. Among the entrusting hospitals with an annual supply capacity of 100 000 to 200 000 instrument packages, the tertiary hospitals accounted for 81.82%(9/11), and the secondary hospitals accounted for 66.67%(6/9), and there was no between-group difference (rate difference: =15.15%,95%CI:-23.17% to 53.47%,P=0.617). CONCLUSIONS The regional centralized sterilization and supply services still face common challenges in emergency support, processing of delicate surgical instruments, safe transportation, and quality control. It is necessary to improve the management systems and strengthen personnel training. For hospitals with high demand for emergency surgical instruments, the priority should be given to establishing in-house sterilization and supply centers so as to ensure the timeliness and safety of surgical instrument reprocessing.