Objective: To survey the current situation of radiological protection in primary medical institutions in Xi′an, analyze the existing problems, and provide countermeasures and suggestions for further strengthening the radiological protection management of radiological diagnosis and treatment in primary medical institutions. Methods: A total of 58 primary medical institutions in Xi′an were selected by stratified cluster sampling according to the work plan of national radiological health monitoring project and the related implementation plan in Shaanxi province. Data were collected by using a unified design questionnaire to investigate and analyze the basic protection situation, radiological diagnosis and treatment equipment, protective auxiliary equipment and their use situations as well as the standardization of the machine room of these radiological diagnosis and treatment institutions. Protective monitoring of the machine room was conducted by the Radiological Health Department of Xi′an CDC together with the relevant data being recorded. Results: The survey found that the holding rate of the license of radiological diagnosis and treatment in primary medical institutions was 96.6%, the ratio of professional and technical workers with professional expertise in radiological diagnosis and treatment 89.6%, the training rate of radiological staff 89.6%, and the proportion of protective equipment 85.7%, the utilization rate of protective equipment 74.3%, the rate of physical examination for radiation workers 91.4%, and the rate of personal dose monitoring 96.5%. There was no statistically significance in the area and at the shortest side of the machine rooms between different types(P>0.05). There were statistically significances in ventilation (χ²=7.034, P<0.05), tidiness (χ²=29.075, P<0.05), warning sign equipment (χ²=23.156, P<0.05) and status indicator light equipment (χ²=23.478, P<0.05) between different types of primary medical institutions. The qualified rate of radiation protection in the workplace of the radiological diagnosis and treatment institutions was 74.1%, and the difference in radiation dose levels in the surrounding environment of the workplace of the radiological diagnosis and treatment institutions between different types was statistically significant (χ²=14.028, P<0.05). Conclusions The patients′personal protective equipment allocation rate and the utilization rate of examined individuals′ protective equipment in the primary medical institutions are low, the standardization of the radiation workplace is poor, and the radiation protection in the workplace needs to be improved.