Clinical pathway management is an important part of public hospital reform, providing great significance for regulating medical behavior, improving medical quality, and controlling unreasonable medical expenses. In December 2020, a tertiary hospital conducted clinical pathway management practices based on clinical decision support systems. Through segmented design of clinical pathways, dynamic adjustment of pathway execution process, quality control throughout the entire process, and performance evaluation and continuous improvement, the management level of clinical pathways was comprehensively improved. After one year of practice, the hospital clinical pathway management based on clinical decision support systems had achieved good results. The average days of stay of patients decreased from 6.58 d in 2020 to 6.32 d in 2021, the proportion of admitted patients to discharged patients increased from 63.10% to 67.47%, the admission rate increased from 88.32% to 90.43%, and the variation rate decreased from 20.03% to 15.00%. This management practice provided a reference for public hospitals in China to improve the quality and efficiency of clinical pathway management.