Governance of public hospitals has become an important consideration in China. Research is being conducted, consultants are being engaged, and new models are being tested to determine how a change in governance can positively affect health care reform. The United States is looked to as an example for hospital governance. Old principles and new trends for boards of directors of hospitals are discussed. Critical thought is given as to the governance principles that can be applied in China which will augment the changes taking place to make hospitals more autonomous under health care reform. Recommendations are made by the authors as to which of these principles and new methods should be considered to be adopted for China’s public hospitals. Governance of public hospitals has become an important consideration in China. Research is being conducted, consultants are being engaged, and new models are being tested decide determine how a change in governance can positively affect health care reform. The United States is looked to as an an example for hospital governance. Old principles and new trends for boards of directors of hospitals are discussed. Critical thought is given as to the governance principles that can be applied in China which will augment the changes taking place to make hospitals more autonomous under health care reform Recommendations are made by the authors as to which of these principles and new methods should be considered to be adopted for China’s public hospitals.