Objective To investigate the current situation of early essential newborn care and related health care service in health facilities of four provinces in Western China,so as to provide basis for developing targeted intervention. Methods A mail survey was conducted to collect data in the midwifery health facilities of Guizhou,Qinghai,Sichuan,Ningxia from June 2017 to September 2018.Descriptive statistical analysis was used to compare implementation rates of early essential newborn care interventions.Chi-square test was used to compare rates among different level of facilities. Results Totally 233 health facilities from county and township participated in the study.1) In terms of perinatal care service,the surveillance rate of high-risk pregnancy (98.9%),the treatment rate of pregnancy with syphilis (97.9%),folic acid consumption rate of pregnant women (88.8%) were relatively high.The rate of antibiotics usage among mothers with premature rupture of membranes was relatively low (60.1%).2) In terms of newborn care service after delivery,the rate of skin-to-skin contact in 90 minutes after birth was 41.8%.Early initiation of breastfeeding rate in 1 hour after birth was 77.7%.And 24.7% of health facilities could implement kangaroo mother care for preterm newborns.3) In terms of the treatment for newborn common diseases,the proportion of facilities that could diagnose and treat neonatal sepsis and neonatal pneumonia was 33.5% and 47.8%,respectively.And the rate for newborn receiving intramuscular injection of vitamin K₁ was 69.8%. Conclusion s There are gaps between the current early essential newborn care and the WHO recommendations in health facilities of county and township in four provinces of Western China.So targeted interventions are suggested to be developed to address these gaps.