ObjectiveTo systematically review the current prevalence, key determinants, and prevention strategies of childhood obesity in China. MethodA retrospective review of recent domestic and international literature and policy documents related to the epidemiological trends, health impacts, risk factors, and intervention strategies for childhood obesity was conducted, supplemented by national surveillance data and clinical practice updates. ResultsThe prevalence of childhood obesity in China had been rising continuously over the past four decades, with particularly high rates observed among primary school children and boys. Recent trends showed a “provincial reversal” and an “urban-rural reversal”. The complex interplay of factors at the family, school, and societal levels contributed to the high-risk environment for obesity. China had developed a relatively comprehensive policy framework for obesity prevention and control and was promoting a three-tier prevention strategy. Clinically, pharmacological and surgical interventions were being gradually adopted, and traditional Chinese medicine also showed potential. However, challenges remain, including limited health insurance coverage. ConclusionsChildhood obesity has become a significant public health issue in China, threatening national health and social development. Future efforts should focus on enhancing intersectoral governance, improving early intervention capabilities, expanding health insurance support, and standardizing clinical practices. A multi-level, multi-pathway integrated prevention and control system is essential for effectively curbing childhood obesity under the Healthy China strategy.