Objective Healthcare system now, with global budget payment, is facing an increasing challenge mainly due to patient oriented environment, more demand for service quality and organizational re-arrangement. Also due to the high cost of personalle and equipments in the operation room , it is quite important to maintain the high efficiency of management to encompass high volume of surgeries. Staffing and scheduling is the most important issue in the management of the operating room and has direct impact on the operational efficiency, cost and revenue. The purpose of this study is to investigate the influence of staffing and scheduling of the operating room on its efficiency. How we control the sum of the patients requiring operation under present circumstances lies on whether or not we have efficient management of the operation room. The most important part among it depends on the ability of schedule arrangement, which directly influence the performance audit and cost. Materials and Methods:The purpose of this study is to discuss the impact of schedule arrangement on cost in the operation room of one medical center. Retro spective descriptive design. Those first operations performed from July 1st, 2003 to June 30th, 2004 were collected into the controlled group while those performed from July 1st, 2004 to June 30th, 2005 were gathered into the experimental group. Indicators of the effect including the sum of the patients receiving operation, the utilization rate of the operation room, the cancellation rate of scheduled operation, the number of overtime nursing staff and overtime payment, the delayed rate and time of the first operation. We use ANOVA, x2 test, multiple logistic regression and t test to analyze these data. We will discuss issues as the followings to smooth our operation schedule: the arrangement of the fist operation by program manager, setting up a flow chart for nursing staff while admitting the patients, establishing a check-in flow chart for patients of out-patient department and deployment of pageboys. Results: The data showed that the incidence of delaying surgery were decreased by 8.4% in the experiment group as compared to the control group. The operation room occupation rate increased to 84.3% in control group, as compared to 78.25% in experiment group. There is 0.76% decrease in the rate of canceling operation schedule . The number of nursing staff who worked overtime and the overtime payment decreased significantly. The time needed from patients entering operation room to the operation began also decreased significantly. The rate of delaying the first scheduled operation decreased from 52.8% to 12.3%. Conclusion: Operation room managers, leader in department of surgery, and hospital managers could take our results as reference in improving efficiency and decreasing cost.