Introduction: This review outlines the development of China's primary care system, with implications for improving equitable health care.

Sources of data: Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed.

Areas of agreement: Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging.

Areas of controversy: The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration.

Growing points: Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established.

Areas timely for developing research: Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges.