Hospital performance possesses strategic significance in achieving an essential completive advantage for the public hospitals. This study aimed to examine the relationship between patient safety culture (PSC) and the performance of traditional Chinese medicine (TCM) public hospitals in Sichuan, China. To address the research purpose, this study analyses the hospital performance and Patient safety culture in traditional Chinese medicine public hospital in China. We examine the propose model by analyzing cross-sectional survey data from 194 clinical directors at 194 public traditional Chinese medicine hospitals using the Partial least squares structural equation model in Smart PLS 4.0. This study provides predictive evidence that PSC in unit management and management support can lead to better patient safety outcomes. The results revealed patient safety outcomes significantly and positively effects of patient safety related to unit management and management support on overall hospital performance (p-value: 0.000–0.003).