The study analyzes the implementation status of the record keeping system for clinical drug trial institutions in Sichuan Province and suggests quality improvement strategies. As of September 9, 2025, China had 1,803 registered GCP institutions, with Sichuan ranked 7th with 88 institutions. The distribution in the province is uneven with an HHI of 0.25, where Chengdu accounts for 50% (44 institutions), while in western and northeastern Sichuan the coverage is below 30%. Internal medicine dominates the fields (57 institutions, 64.77%), 22 institutions have Phase I clinical research units. There are 1,424 registered principal investigators (PIs), but only 32.7% are from institutions outside Chengdu. Chengdu Fifth People's Hospital has carried out 203 projects, including 26 bioequivalence trials. The system has expanded clinical trial resources, but regional disparities, suboptimal specializations, and quality deficiencies persist.