This is the fifth annual China report of the Lancet Countdown on health and climate change, the flagship report for tracking progress, or lack thereof, on climate change and health in China. Over the years, what began as the marginal effort of a few dedicated individuals has grown into a considerable movement at the forefront of global climate and health discourse. The report is led by the Lancet Countdown Asia Centre, with contributions from 77 experts across 26 institutions.