Objective To establish the pushing transmission model of tendon-sheath system (TSS) for endoscopic flexible instrument, and study the key influencing factors of transmission efficiency. Methods The force and displacement transmission models of TSS in pushing configuration were built and simulated. The tendon-sheath transmission testing platform was designed to validate the model. The influencing factors, such as transmission velocity, tendon-sheath diameter ratio, curvature radius, were explored using this setup. Results There were obvious nonlinear phenomenon in force and displacement transmission. The model simulation results accorded quite well with the experiment results. Transmission velocity, tendon-sheath diameter ratio, curvature radius all had great effects on pushing force transmission of endoscopic flexible instrument, while they had a smaller effect on displacement transmission. Conclusions The proposed model can be used for calculating pushing force transmission of tendon-sheath system for endoscopic flexible instrument, so as to provide the doctors with force feedback at the tip of the end effector, and ensure the safe operation and improve the surgical effects. For better design and control of endoscopic flexible instrument, the transmission velocity, tendon-sheath diameter ratio, curvature radius must be comprehensively considered.