Objective:To evaluate different cost accounting methods in hospitals and analyze the development tendency. Methods: The cost accounting methods which used in most hospitals were sorted, induced and analyzed based on a number of published Chinese literature. The cost accounting research methods in resent years in many respects was snmmarized as follow: cost accounting for large medical apparatus and instruments, cost accounting for the DRG and drugs. Results and Conclusion: It is suggested that the development tendency of the cost management is cost predicting, cost controlling and cost appraising. The only way to accord with the demand of the medical insurance system reform is to think highly of the basis work of cost accounting and to strengthen the hospital management inside.