Abstract: Objective To reveal the current status of competency development needs among primary health care (PHC) managers in China and to analyze the impact pathways of their character strengths on these needs, providing evidence-based recommendations for improving the quality of primary health care services. Methods Using a stratified sampling method, 369 PHC managers from 11 cities in Zhejiang Province were studied from June to September 2023. Their Character strengths and competency development needs were surveyed by the Chinese Virtues Questionnaire (CVQ-96) and the Competency Development Needs Scale. Hierarchical linear regression analysis was employed to explore the impact of character strengths on competency development needs. Results The mean scores of character strengths and competency development needs of 369 PHC managers were (4.03 ± 0.60) and (4.43 ± 0.60), respectively. Hierarchical linear regression indicated that the Interpersonal dimension of character strengths positively predicted all four dimensions of competency development needs (β = 0.285 to 0.422, P < 0.001). The Prudence dimension had a significant positive effect on the needs for professional knowledge and basic management skills (β = 0.269 and 0.226, respectively; P < 0.05). Conversely, the Vitality dimension did not show statistically significant predictive effects across any dimension of competency development needs in the multifactorial model (P > 0.05). Conclusions Primary health care managers demonstrated a strong demand for professional competency development, and character strengths served as a critical influencing factor of these needs. It is recommended that primary health care institutions implement comprehensive training needs assessments, prioritize the enhancement of PHC managers’ interpersonal communication skills, and precisely stimulate individual internal drivers for competency development.