Background and objectives: In order to optimal use of resources and reducing costs, many countries use different strategies such as downsizing. Therefore, this study was implemented to evaluate different downsizing methods in teaching hospitals of Tabriz and Ardabil cities.

Material and Methods: This study was a descriptive study conducted in 2015 and 2016 in order to identify downsizing methods in teaching hospitals in Tabriz and Ardabil cities. A researcher-made questionnaire was used for data collection. Its content validity was approved by five university professors in health economic and health services management. SPSS v20 software and descriptive statistics were used for data analysis.

Results: Among 13 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 especially outsourcing and cooperation have been used widely in teaching hospitals of Tabriz and Ardabil universities of medical sciences. It seems that precise planning, variety in applied methods and hospital circumstances are important factors in achieving the downsizing goals.