OBJECTIVES: To review studies that investigated the costs and resource use of managing major depressive disorder (MDD) in China.    METHODS: A structured literature review on published articles in both English and Mandarin languages was conducted. Literature search was conducted using PubMed, Cochrane, Wan Fang, and VIP databases. Articles published between 2000 to 2013 were selected. The inclusion criteria included studies conducted in China, and studies that reported direct and indirect costs in MDD management, including factors that affected these costs, as well as resources used in managing MDD. Four reviewers (two for each language) independently selected and reviewed the articles. Direct cost included costs of MDD treatment (e.g. medication, investigation, hospitalisation, nursing care…etc.); whereas indirect costs included caregiver cost, productivity loss, and mortality (suicide). RESULTS: A total of 24 articles in Mandarin and English were selected and reviewed. Based on the review, direct cost for MDD reported ranged from RMB 1,000 to RMB 6,000, whereas indirect cost reported ranged from RMB 2,000 to RMB 51,000. Loss of productivity, when evaluated, accounted for more than 75% of indirect costs. Serotonin norepinephrine reuptake inhibitor (SNRI) incurred the highest direct medical cost compared to selective serotonin reuptake inhibitor (SSRI), followed by tricyclic antidepressants (TCA). The treatment costs for MDD had increased gradually over the years. Some of the common factors affecting the cost of MDD management included treatment duration, payment methods, types of drug prescribed, comorbidity, disease severity and marital status. Studies had shown that most patients first seek treatment in general clinic or hospitals (76%) and only a small percentage of patients (23.7%) was first treated by mental health specialists. CONCLUSIONS: The reported cost of managing MDD in China was high. Most patients first seek treatment in general medical clinics or hospitals instead of mental health specialists.