China has emerged as a global economic powerhouse after four decades of unprecedented growth. Such growth has generated many environmental challenges with enormous ecological, socioeconomic, and health consequences in China and beyond. Although the overall quality of air and water is starting to improve, both are still below national and international standards. Water shortages are widespread. Biodiversity continues to decline. China is the world's top CO2 emitter, although per capita emissions are much lower than those of developed counties. On the positive side, large national conservation programs have been implemented, including the Natural Forest Conservation Program, the Grain-to-Green Program, Ecosystem Functional Conservation Areas, and Ecological Protection Redlines. More than 2,750 nature reserves have been established and a new national park system is being constructed. Some endangered and threatened species, such as the giant panda, are showing signs of recovery, and forest cover and some ecosystem services have increased. These mixed environmental outcomes result from human-nature interactions within China as well as between China and adjacent and distant countries. These include increasing rapid economic growth, resource consumption, land use change, trade and investment, and conservation and development policies. We suggest systems approaches such as nexus approaches and flow-centered governance to help China achieve ecological civilization and become an environmental leader on a metacoupled planet.