After 30 years of unbridled economic growth China is now facing tremendous challenges from urban air pollution, toxic emissions from industry and power plants, pollution of waterways and compromised foodstuff safety. Those aspects of environmental degradation most directly impacting human welfare have seen the strongest outcry from the public, resulting in both organised civil society activity and endless spontaneous protests. Today, environmental and food safety may constitute the most important threats to political stability. This chapter will outline relevant data on welfare issues relating to climate and environment in the broadest sense, and discuss State and media responses, new legislation, public opinion and the role of civil society organising. The chapter argues that China has come to an important juncture in its striving towards sustainable development, and that real change in environmental practices is questionable without simultaneous political change and a greater space for non-State actors. However, State–society relations remain ambiguous, hampering those ‘social forces’ that may contribute efficiently to reaching an environmental turning point, as well as hampering general public mobilisation for substantial improvements in environmental welfare. Finally, the chapter frames China’s present environmental health issues in a broader historical perspective, contending that the country is currently in a transitional state between inherent and modern perspectives on the environment, and that we must look beyond the shifting politico-economic arrangements in the contemporary era to appreciate the long-term processes in State–society–environment relations.