Past, present and future epidemiology of echinococcosis in China based on nationwide surveillance data 2004-2022. We evaluated the epidemiological characteristics of echinococcosis, a global public health threat, in China to inform global control efforts. Descriptive, statistical, cluster, spatial, and trend analyses were used to evaluate the epidemiology at national, provincial, and county levels based on 2004-2022 nationwide surveillance data from China. Between 2004 and 2022, China recorded 72,676 cystic echinococcosis (CE) cases, 11,465 alveolar echinococcosis (AE) cases, and 5703 others, with an average annual cases per million (ANpM) of 3.45. Females had a higher incidence (ANpM = 3.87) than males (3.05), with most cases (41.15%) in the 30-49 age group, mainly among herders (38.76