Background and aims: many countries use different strategies for example downsizing in order to optimal use of resources and reduce costs. Therefore, this study was implemented to evaluate of different downsizing methods in public hospitals of Tabriz and Ardabil cities.

Methods: This study was a descriptive study that was conducted in 2015 and 2016 in order to identify of downsizing methods in public hospitals in Tabriz and Ardabil cities. A self-made questionnaire was used to data collection. Its content validity was approved by five university professors in health economic and health services management. SPSS 20 software and descriptive statistics was used for data analysis.

Results: A total of 13 of downsizing methods, 11 methods were used in Tabriz hospitals and 6 methods were used in Ardabil hospitals. Outsourcing and cooperation between hospitals were the most frequent methods. Cost reduction was the most important goal of downsizing. Also, performance evaluation was the most important control mechanism after downsizing.

Conclusion: The findings showed that the downsizing method specially Outsourcing and cooperation have been used widely in public hospitals of Tabriz and Ardabil universities of medical sciences. It seems precise planning, variety and hospital circumstances are important factors in achieving the downsizing goals.