In view of total quality management and based on the theory of medical quality cost,total medical quality cost and its constituent ratio in one A level tertiary hospital in 2006-2008 was analyzed. The differences between actual constituent ratio and theory ratio were discussed. The structure of medical quality cost in the hospital was described. The ratio of control cost in total medical quality cost was much high. The approaches of improving quality cost such as creating dynamical quality cost concept,developing quality training and establishing standard diagnosis and treatment guideline were mentioned.