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Purpose: This study was conducted to compare the characteristics of organizational structure and occupational satisfaction among nurses in general hospital and small to medium-sized hospital and to investigate the affecting factors on their occupational satisfaction. Methods: The study was based on the cross-sectional descriptive survey. A self-report questionnaire was used to collect data from 343 nurses between June and July, 2010. Data were analyzed by x2-test, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, and multiple regression using the SPSS/WIN 14.0 program. Results: Hierarchical structure was dominant in general hospital whereas relationship was highly valued in small to medium-sized hospital. Occupational satisfaction was positively correlated with work environment built on relationship, innovation and tasks. Factors significantly influencing on occupational satisfaction in general hospital included innovative work environment, nurses' income and their health status (R2=40.3%). For the small to medium-sized hospital, they included innovative work environment, satisfaction in life, tasks and professionalism (R2=40.4%). Conclusion: Organizational structure, especially innovative work environment and relationship-oriented attitude had a significant influence on nurses' occupational satisfaction. Therefore, nursing administrators have to develop and consider organizational structure to improve occupational satisfaction.