Objective To investigate and compare current situation of palliative care (PC) services between cancer hospitals and tertiary general (TG) hospitals in China from the perspective of hospital leaders. Methods An electronic questionnaire survey was conducted on the directors of 206 cancer hospitals and 443 TG hospitals nationwide, which including the form and content, plans for the future years, and obstructing factors for discipline development of PC services. SPSS statistics 16.0 was used for statistical analysis. Intergroup comparison was performed using student′s t test, Fisher exact test or Chi-square test depending on different data type. Results The leaders of 88 cancer hospitals (42.72%) and 174 TG hospitals (39.28%) completed the questionnaire, with those of cancer hospitals having a higher ratio of participating than those of TC hospital (P<0.01). In the past 10 years, 78.74% (137/174) of TG hospitals and 85.23% (75/88) of cancer hospitals provided PC services, and at present, this ratio was increased to 87.59% (120/137) and 90.67% (68/75), respectively, though no statistical difference was seen. There were 48.53% (33/68) cancer hospitals and 40.83% (49/120) TG hospitals having PC specialists (P=0.31), and 27.94% (19/68) cancer hospitals and 17.50% (21/120) TG hospitals had PC outpatient department (P=0.09). These cancer hospitals had significant better advantages in consultation [29 hospitals (42.65%) vs 33 hospitals (27.5%)], inpatient beds [28 hospitals (41.18%) vs 32 hospitals (26.67%)], and affiliated hospices[20 hospitals (29.41%) vs 20 hospitals (16.67%)] when compared with the TG hospitals (all P<0.05). In general, both types of hospitals were significantly improved in PC service and analgesic treatment compared with the conditions of 5 years ago (P<0.01). Both types of hospitals supported the opinion on the integration of palliative care and oncology care, with a mean score of (7.06±3.19) and (6.29±3.64) points in cancer and TG hospitals, respectively (P>0.05). The cancer hospitals showed higher approval rate for increasing scientific research projects than the TG hospitals [(7.24±3.12) vs (5.91±3.71)points, P<0.01]. The top 3 obstructing factors for discipline development of PC services were lacks of reimbursement support, PC specialists and budget in order. Conclusion Although more than 85% of cancer and TG hospitals can provide PC services nowadays, less than 50% of them offer PC specialists. Both types of hospitals have made great improvement in PC service and analgesic treatment, but the cancer hospitals show significant advantages in PC consultation, inpatient beds and affiliated hospices. Lacks of reimbursement support, PC specialists and budget are top 3 obstructing factors for development of PC services.