The issue as to whether hospital ownership has an impact on the quality of care has long been a serious concern. Hand hygiene (HH) compliance is regarded as an important indicator of the quality of care in the control of hospital-acquired infections. However, little information is available on whether hospital ownership influences HH compliance. In this study, of 229 hospitals selected from Hubei province in China, 152 were public and 77 were private hospitals. A total of 23 652 healthcare workers (HCWs) were surveyed, using a convenience sampling. HH compliance, the WHO's "My Five Moments for hand hygiene" (5MHH), among HCWs, together with the factors of hospital ownership, training frequency, bed occupancy rates, etc. were collected. Univariate analysis and ordinal logistic regression analysis were used to analyze factors affecting HH compliance. Overall, HH compliance rates were 67% and 79% for public and private hospitals, respectively. The HH compliance rates of HCWs and 5MHH were between 55% and 95%, and influenced by hospital ownership (P < 0.05), excluding compliance rate at the moment after body fluid exposure, and other influence factors included training frequency and bed occupancy rate (P < 0.05). HH compliance is better in private than in public hospitals. Hospital ownership is a significant factor affecting HH compliance, in addition to training frequency and bed occupancy rate.