Since 1949, China has undergone enormous demographic and epidemiologic transformations. Demographically, China has become one of the world’s fastest ageing countries and has the world’s largest ageing population. Epidemiologically, China has shifted from carrying a heavy burden of infectious diseases to chronic, non-communicable diseases (NCDs). Since 2010, cancer has become the leading cause of death in China. The combined forces of population ageing and epidemiologic transition to NCDs have imposed heavy financial pressure on both the government and citizens. There is a pressing need for the government to ensure a sustainable health care financing system and affordable care for its people. This chapter gives a detailed account of demographic and epidemiologic transformations in China since 1949, and identifies and examines reasons causing such transformation. It also examines the implications of population ageing and epidemiological transitions for health financing.