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Purpose: The doctor–patient relationship (DPR) in People's Republic of China is very tense. This study aimed to provide some explanation by exploring factors influencing the DPR from doctors' and patients' perspectives. Methods: A cross-sectional study was conducted in one provincial and one city-level general public hospital in Inner Mongolia Autonomous Region of People's Republic of China. The Difficult Doctor–Patient Relationship Questionnaire (DDPRQ-10) and the Patient–Doctor Relationship Questionnaire (PDRQ-9) were used to assess the quality of the DPR from 226 doctors, and 713 patients' perspectives, respectively. Multivariate linear regression was used to identify factors significantly associated with the doctors' and patients' perceptions of the DPR by assessing coefficients of total effect and their 95% confidence interval. Results: The result revealed that provincial-level doctors had a higher DDPRQ-10 score than city-level doctors. Worse DDPRQ-10 scores were seen for doctors who worked in the Internal Medicine departments were aged between 31 and 40 years, held a master's degree, were dissatisfied with their income, worked more than 40 hrs per week, felt pressure at work, considered the hospital environment to be bad, often felt affected by negative media reports and had defensive behaviors. Patients visiting the provincial hospital had a lower PDRQ-9 score than those from the city-level hospital. Lower PDRQ-9 scores were also seen for patients who were of Mongolian ethnicity, were dissatisfied with their income, waited longer to see the doctor, had a shorter doctor consultation time, had lower expectations of their treatment result, had a low level of trust in the doctor, regarded the hospital environment as bad and those who were frequently influenced by negative media reports. Conclusion: This study may provide a useful model to raise the quality of the DPR and to supply evidence for health policy makers and administrators to formulate strategies for reducing the problem of tense DPR in Chinese hospitals. [ABSTRACT FROM AUTHOR]