Background. When the mandatory premarital examination requirement in China was cancelled in 2003, the rate of participation dropped sharply. This study examined the levels of exam satisfaction and the factors influencing satisfaction in the Hubei Province. Methods. Graduate students administered 650 questionnaires, and 633 questionnaires were returned. Regression analysis was used to analyze satisfaction. Results. The study found high levels of satisfaction, even though the exam participation rate was only 34.8%. A regression model for satisfaction showed that the most important objective factors were female sex (P < .05), specific city (P < .05), and level of education (P < .01); 2 important subjective variables were the level of understanding of the premarital examination (P < .01) and satisfaction with medical services of the premarital examination (P < .01). Conclusions. Satisfaction with the premarital examination might be increased by efforts to increase the level of understanding of the premarital examination and to improve medical services.