Objective,2,This study aimed to investigate the application of an optimized management process in the management of external instruments in the central sterile supply department (CSSD).,Methods,2,The 6 645 external instrument packages before process optimization from January to March 2023 were set as the control group, and 6 576 external instrument packages after optimization from April to June 2023 were set as the observation group. The management quality of external instruments was compared and the operating room's feedback was analyzed.,Results,2,In the observation group, the unqualified rates of instrument cleaning, power tool cleaning, packaging, sterilization, and distribution recorded in the checklist of external instruments were significantly lower than those in the control group, and the difference was statistically significant (,P,<,0.05). Before and after the optimization of the management process, the rate of non-recycling, cleaning and sterilization after use in the operating room were all 0. Additionally, in the observation group, the feedback supply timeliness rate, sub-packaging completeness rate, and supply satisfaction rate in the operating room were higher than those in the control group, and the difference was statistically significant (,P,<,0.05).,Conclusion,2,The optimized management process of external instruments in CSSD emphasizes the division of labor among each staff member, which enhances performance efficiency, and thus is worth being promoted in CSSDs.