This chapter explains why environmental health issues carry profound implications for China’s future and how they threaten to severely weaken the nation’s economic growth, undermine its sociopolitical stability, and complicate China’s foreign relations.Environmental health issues not only exact a significant economic toll but also have profound sociopolitical implications. With the growing public attention on air quality, pollution has increasingly become a political issue that tests the Chinese government’s ruling capacity. The environmental health problems, in conjunction with other mounting domestic challenges, will constrain Chinese leaders’ ability to mobilize the resources and internal support necessary for China to play a global leadership role.