Objective To construct and explore the implementation effect of a voice follow-up system among patients with hypertension and diabetes. Methods A medical knowledge base was established based on the manual telephone follow-up data of 4 087 patients with hypertension and diabetes in the hospital in the past 5 years. A speech template was formed and a voice follow-up system based on intelligent speech technology was constructed. Patients discharged from the Department of Internal Medicine with diagnosis of hypertension and diabetes mellitus from April 2022 to March 2023 were recruited as the study participants. The voice follow-up system was applied to replace the traditional manual follow-up method among these patients. Effect of patient follow-up，the accuracy of data collection，the accuracy of man-machine answering，and the satisfaction of follow-up was collected. Results The total number of follow-up visits was 1 489，and the follow-up success rate was 73.7%. Five hundred patients were randomly selected from the group of follow-up successful patients for the analysis of follow-up recording data. The difference in the follow-up success rate of patients with different age was statistically significant（χ²=38.861，P<0.001）. Besides，the accuracy rate of data collection for patients with or without previous follow-up experience（χ²=4.970，P=0.026） and the accuracy rate of man-machine answering（χ²=7.010，P=0.008） differences were both statistically significant. In addition，different literacy levels（χ²=13.467，P=0.001），and age groups（χ²=15.062，P=0.002），accuracy of patients’ human-computer responses were statistically significant and the satisfaction rate of the follow-up visit was 91.2%. Conclusion The voice follow-up system has good acceptance and practicability among hypertensive and diabetic patients，can save manpower，improve the efficiency of follow-up，and is more suitable for people with younger age，higher education level，and familiar with the hospital follow-up process. The voice follow-up system is worthy of popularization and application in the future.