Abstract: OBJECTIVE To introduce the methods and practices of constructing a structured pharmacy decision-making knowledge database of the Shanghai Jiao Tong University Affiliated Sixth People's Hospital. METHODS First, structured pharmaceutical decision knowledge database was constructed based on multi-faceted clinical medication information, including drug instructions, record information, dispensatory and clinical guideline. Then the database was constructed and tested. Third, the medication rules were revised by 5-step circular update mechanism. At last, the proportion and composition of unreasonable medical advice in the first half from 2016 to 2018 were compared. RESULTS After screening and listing the structured drug application information according to the characteristics of usage, contraindications, idication, interaction, compatibility, special population medication and so on, tested the database through trial operation. Then, after passing the discussion by the Pharmaceutical Management and Drug Treatment Committee, the knowledge database of structured pharmacy decision-making was set up online to run, that including more than 10 000 drug rules, involving about 1 500 kinds of drugs. The system had been launched since the beginning of 2017. Since then, it reduced the proportion of unreasonable medical orders from 6.02% to 2.07%, while significantly changed the composition of unreasonable of medical and promoted the improvement of the quality of pharmaceutical services. CONCLUSION The structured decision-making knowledge can not only improves the efficiency and quality of medical services, but also improve the management level of drug safety usage.