The health effects of environmental risks, especially those of air and water pollution, remain a major source of morbidity and mortality in China. Biomass fuel and coal are routinely burned for cooking and heating in almost all rural and many urban households resulting in severe indoor air pollution that contributes greatly to the burden of disease. Many communities lack access to safe drinking water and santiation, and thus the risk of waterborne disease in many regions remains high. At the same time, China is rapidly industrializing with associated increases in energy use and industrial waste. While economic growth resulting from industrialization has improved health and quality of life indicators in China, it has also increased the incidence of environmental disasters and the release of chemical toxins into the environment, with severe impacts on health. Air quality in China's cities is among the worst in the world and industrial water pollution has become a widespread health hazard. Moreover, emissions of climate-warming greenhouse gases from energy use are rapidly increasing. Global climate change will inevitably intensify China's environmental health problems, with potentially catastrophic outcomes from major shifts in temperature and precipitation. Facing the overlap of traditional, modern, and emerging environmental problems, China has committed substantial resources to environmental improvement. China has the opportunity to both address its national environmental health challenges and to assume a central role in the international effort to improve the global environment.