BACKGROUND This study provides a description and analysis of the development of occupational diseases in China as recorded in the official statistics during the period 2000-2010, identifies major challenges, and explores possible solutions for prevention and control. METHODS In-depth textual analysis and data analysis of China's annual national reports of occupational diseases, as well as of corresponding policy and regulation documents. RESULTS The number of recorded cases of occupational diseases increased rapidly in China between 2000 and 2010. Pneumoconiosis was the most prevalent category of occupational diseases. Chemical poisonings accounted for 13% of the cases of occupational diseases. CONCLUSIONS Difficulties in diagnosis and inefficient surveillance are major impediments to the mitigation of occupational diseases. The new definition of occupational disease has provided an opportunity to enlarge the Catalogue of Occupational Diseases. Improved coordination of the different chemical regulations meant to protect human health may also facilitate the prevention of occupational disease.