Abstract: OBJECTIVE To assess and compare the household accessibility of medicines in Beijing, Chengdu and Lanzhou under the background of the new medical reform. METHODS Multistage stratified sampling approach was employed and about 825 households were included in Beijing, Chengdu and Lanzhou. Questionnaire survey was conducted to each household. RESULTS Total 727 valid questionnaires were collected(281 for Beijing, 207 for Chengdu, 239 for Lanzhou). Among the respondents, 26.3%, 48.3%, 35.6% households experienced acute illness in the past 2 weeks; 86.0%, 91.2%, 94.5% of them were able to take medicine as prescribed; 27.7%, 40.2%, 39.7% of them took antibiotics. 71.9%, 59.4%, 66.5% households reported chronic illnesses patients, of which 89.9%, 93.0% and 70.0% were able to adhere the prescription in Beijing, Chengdu, and Lanzhou. In addition, 90.0%, 93.7%, 91.2% of the households store medicine in their home. In terms of accessibility, 59.4%, 71.6% of the households were able to reach the nearest public health institution within 15 min in Chengdu and Lanzhou, while only 23.8% in Beijing. CONCLUSION The accessibility of household medicines in the three cities has improved significantly, but there are still problems. It is recommended that relevant departments to further raise residents' awareness of the importance of pharmaceutical services, and take measures to improve the medical insurance system and payment methods. They also should effectively improve the level of medical treatment for patients and the affordability of household medicines.