Objectives: To understand how clinical environment affects acupuncture practice in general hospitals, Chinese medicine (CM) clinics and hospitals. Design and Outcome Measures: A self-reported questionnaire comprising questions of demographic data, general use of acupuncture and other CM therapeutic methods, and diagnosis/treatment of low back pain, was adopted in this cross-sectional survey and sent to 867 CM physicians. Results: 403 questionnaires were sent to general hospitals and Chinese medicine hospitals and 464 to the Chinese medicine clinics. In the first group177 questionnaires were returned (we excluded 15 incomplete questionnaires), and the response rate was 40.2%. In the second group, 206 questionnaires were returned (we excluded 19 incomplete questionnaires), and the response rate was 40.3%. The respondent physicians practicing in general hospitals were more often female, younger and had less clinical experience but were more involved in teaching and publishing articles. A majority of them graduated from a School of Chinese Medicine (45%); or the School of Post-baccalaureate Chinese Medicine (50%). The proportion of doctors certified by the Special License Qualification Examination was higher (39%) in clinics than in hospitals (5%). Significant differences appeared between general hospitals versus CM clinics and hospitals regarding the frequency of use of therapeutic methods, the categories of disease treated by acupuncture, the chosen diagnostic techniques, as well as the needle retention time, and the frequency of treatment per patient. There were no substantial differences with regards to needle techniques and the choice of acupuncture points. Conclusion: This study suggests that the clinical setting can considerably influence the use of acupuncture such as the categories of disease treated, the retention time of the needles, and frequency of treatment. Factors such as gender, training, and the number of years of clinical experience of the physician also played a part.