Abstract: Objective: To build the performance appraisal system in operation room and analyze the clinical application effect. Methods: Construct operating room performance appraisal system framework, including operative cooperation difficulty, total working time, overtime, job title, plus and minus items. Analysis the operation room clinical comprehensive nursing quality, employees satisfaction, and surgeons and anesthetist evaluation on nursing staff. Results:Obvious improvement was found in the operation room clinical comprehensive nursing quality. Employees satisfaction of performance appraisal system among nurses was improved, and the difference was statistically significant (P<0.05).Surgeons and anesthetists were more satisfied over nurses performance on the following areas: preparation, checking,operative cooperation, job responsibilities, self-motivation, and attitude (P<0.05). Conclusion: The performance appraisal system in operating room can improve the clinical nursing quality, employee satisfaction and improve the level of holistic nursing in operating room.