Objective To understand the physical examination rate and its influencing factors of patients with severe mental disorders in Qingyang, thereby providing a basis for enhancing the physical examination rate of such patients. Methods The data of patients with serious mental disorders registered in Qingyang in 2022 and the results of physical examination in 2022 were downloaded from the Gansu Province Mental Health Surveillance Information System. Multivariate logistic regression analysis was used to identify factors influencing participation in health physical examination. Results In 2022, 12 063 patients with severe mental disorders were registered in Qingyang, and 7 847 cases underwent free health physical examination, with physical examination rate of 65.050%. Multivariate logistic regression analysis revealed that the following factors were positively associated with patients’ participation in physical examination: age: 18-44 years (OR=1.537, 95%CI: 1.132-2.086), 45-59 years (OR=1.642, 95%CI: 1.192-2.261), ≥60 years (OR=2.671, 95%CI: 1.902-3.752); per capita net income ≤8 000 yuan/years (OR=1.164, 95%CI: 1.070-1.266); age at onset: 45-59 years (OR=1.266, 95%CI: 1.081-1.483), ≥60 years (OR=1.948, 95%CI: 1.510-2.514); diagnosis: mental retardation accompanied by mental disorders (OR=2.475, 95%CI: 1.553-3.944), mental disorders due to epilepsy (OR=2.685, 95%CI: 1.677-4.299), bipolar affective disorder (OR=1.976, 95%CI: 1.246-3.133), schizophrenia (OR=1.638, 95%CI: 1.046-2.564), and schizo affective disorder (OR=2.022, 95%CI: 1.207-3.387). The following factors were negatively correlated with patients’ participation in physical examination: marital status: unmarried (OR=0.750, 95%CI: 0.663-0.848), divorced (OR=0.673, 95%CI: 0.563-0.804), widowed (OR=0.700, 95%CI: 0.559-0.876); education level: primary school (OR=0.856, 95%CI: 0.772-0.951), junior high school (OR=0.721, 95%CI: 0.640-0.811), senior high school or technical secondary school (OR=0.589, 95%CI: 0.493-0.702), college and above (OR=0.581, 95%CI: 0.447-0.757), occupation was non-farmer (OR=0.745, 95%CI: 0.651-0.853); guardian type: relatives as guardians (OR=0.759, 95%CI: 0.649-0.887), no guardian or other guardians (OR=0.772, 95%CI: 0.654-0.912). Conclusion The physical examination rate of patients with severe mental disorders in Qingyang needs to be further improved. It is necessary to strengthen the mental health resources of community/township medical and health institutions, improve the physical examination items, and focus on unsupervised, weakly supervised, and unmarried patients to promote their active participation in health examinations.