OBJECTIVES To conduct the cost-utility analysis (CUA) of treatment strategy with ranibizumab recommended by the Chinese Clinical Pathway of age-related macular degeneration (AMD) in China. METHODS Visual acuity data for the as-needed dosing regimen with ranibizumab (RBZ-PRN, administrated every month for three doses, additional reinjections were determined by physicians’ need) were derived from pivotal trials, based on ranibizumab dose of 0.5 mg. Decision tree model and Markov model were developed to estimate RBZ-PRN compared with best supportive care (BSC) for short and long term. The first year decision tree model from a third-payer perspective was performed to estimate CUA in short-term. Then a 10-year Markov model from a societal perspective were constructed (discounted at 5%) in long-term CUA estimation. Resource utilization was obtained from official recommendations in China. The costs of low-vision related disease were extrapolated from meta-analysis. Informal care costs and utility values were estimated by published studies. The uncertainty was identified in a one-way sensitivity analysis and probabilistic sensitivity analysis (PSA). Cost-effective acceptability curves were obtained by a Monte Carlo approach with 1000 repetitions. RESULTS For RBZ-PRN compared with BSC, the incremental cost-effectiveness ratios (ICER) ranged from $90,546/QALY for the 1-year time frame to $9,787/QALY for the 10-year time horizon. As indicated in the PSA, RBZ-PRN was the optimal strategy in 100% of cases below the willingness to pay threshold of $18,278 per QALY gained (3 times Chinese GDP per capita in 2012) for the 10-year model. CONCLUSIONS When administered as needed, ranibizumab is cost-effective compared with BSC from a societal perspective. In China’s current clinical practice, this can be a useful tip for decision-makers who should consider cost-effective issues for the treatment of wet-AMD.