More than 30 years of reform and development have resulted in China’s health services and the health status of its population improving signifi cantly. The key health indicators, particularly in the urban areas in the east of the country, are close to the level of developed countries or moderately developed countries. Whilst still a burden particularly amongst poorer rural communities infectious diseases are being effectively controlled, with a signifi cant reduction in annual incidence from 6,000/100,000 in 1950 to 471.33/100,000 in 2011 [1]. Substantial progress has been made in improving life expectancy and decreasing mortality rates for children under 5 [2]. However, industrialization and urbanization, rapid lifestyle changes and an increasingly ageing population have led to chronic non-communicable diseases (NCDs) – particularly the big four cardiovascular diseases, cancers, chronic respiratory diseases and type 2 diabetes – becoming major threats to public health in China [3]. This chapter describes the burden of disease attributable to NCDs in China. It describes both the predisposing factors and the initiatives being undertaken to stem the rising tide of the epidemic, which is affecting urban and rural areas, and all strata of society.