Objective To analyse the causes and distribution and trends of neonatal screening unqualified blood films in Hefei and to improve the quality of future neonatal screening. Method The unqualified blood films of medical institutions were sorted and counted by year and hospital type. Results From 2009 to 2013,the rate of unqualified blood films was 0.68%,it decreased overall,the highest rate of unqualified blood films was from 2009 to 2010 (1.46%),the lowest was from 2012 to 2013(0.21%).The first cause of unqualified blood films was that the blood film could not be eluted or infiltrated.From the hospital type distribution,the rate and propotion of unqualified blood films from rural township hospital was the highest.The rate of unqualified blood films recalled appeared rising trend overall. Condusions The main causes of the unqualified blood films in Hefei are that the blood does not permeate the film,the blood film could not be eluted or infiltrated and it is polluted,the area size of blood spot is less than 5 millimeter.The distribution of the unqualified blood films does exists difference between hospital categories.The quality of neonatal screening progressed year by year in Hefei.It is need to strengthen training and supervising to midwifery institutions,especially the rural township hospital.