Introduction This review outlines the development of China's primary care system, with implications for improving equitable health care. Sources of data Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed. Areas of agreement Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging. Areas of controversy The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration. Growing points Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established. Areas timely for developing research Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges.