OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality with high financial implications in China. There is an increasing public health concern for COPD due to increase in tobacco smoking and biomass fuel use and an aging population, and the direct and indirect costs are expected to continue rising. The aim of this study was to synthesize published economic studies evaluating healthcare resource use and its associated costs for COPD patients in China.  METHODS: A systematic search was performed in Embase, Medline and Cochrane databases through March 2016 for studies reporting the economic burden of COPD. Articles were included if they provided information on the direct (outpatient, inpatient and medication) and indirect (transportation, nutrition and nursing) costs associated with COPD in China. Where possible, costs reported by the different studies were converted to 2015 US dollars using the consumer price index for medical care.  RESULTS: Eleven economic studies were identified and included in this review. Most studies were retrospective database studies or surveys. Annual total costs ranged from $1964 to $3449 per patient, which would represent 33%-40% of average household income in China. Direct and indirect costs constituted between 85% to 88% and 12% to 15% of total costs respectively. Costs per patient increased with an increase in symptoms, severity, and duration of disease. Hospitalization owing to disease exacerbation was shown to be a major contributor to total costs.  CONCLUSIONS: COPD is associated with a high direct and indirect costs in China. Reducing hospitalization frequency represents one way to reduce the costs. This study highlights a need for strategies aimed at the prevention and management of COPD to reduce the economic burden in China.