OBJECTIVES: China is a big country with a large population. Reproductive health education is not sufficient for women of childbearing age, which leads to high unintended pregnancy (UP) rate. These represent a significant cost to the health care system. This study analyzes the epidemiology and productivity loss of unintended pregnancy in China. METHODS: The study reviewed published scientific articles and policy documents related to unintended pregnancy in China. We retrieved literature from Wanfang and PubMed databases, and searched policy documents in websites of National Bureau of Statistics and National Center for Women and Children’s health, China CDC. RESULTS: Almost 10% of fertile women have UP in China each year. There are four different results of UP, including miscarriage, elective abortion, ectopic pregnancy and delivery. There are two methods of elective abortion, including operation abortion and drug abortion. The costs of operation and drug abortion are about US $131.58 and $100.62 in early pregnancy respectively, and $154.80 and $464.40 in the second trimester respectively. Drug abortion costs are much more in the second trimester because of complications. The incidence of ectopic pregnancy is about 4.4%, and there are three therapeutic methods. The costs of laparoscopic operation and open abdominal surgery are more than drug conservative treatment. The costs are between $309.60 and $1393.19. Delivery has three possibilities. Vaginal delivery accounted for 52.6%, and cesarean section accounted for 46.2%. The incidence of premature birth is about 6.36%. Vaginal delivery and cesarean section will cost about $387.00 and $619.20 respectively. The costs of premature birth range from $928.80 to $1547.99, and the costs will be increased with high likelihood of neonatal weight. CONCLUSIONS: UP poses a heavy economic burden in China, but the economic burden could be reduced if fertile women receive more reproductive health education, get appropriate treatment and have periodical prenatal examination.