China makes a unique and vital contribution to maintaining global and regional waterbird diversity and conservation. Despite considerable historical conservation efforts, the continued loss of waterbird diversity and abundance necessitates a contemporary review of Chinese sites of conservation significance. The Ecological Protection Red Line (EPRL) was proposed by China’s Central Government in 2013 to protect areas providing crucial ecosystem services and provides the opportunity for such a review to enhance waterbird conservation in China. By incorporating various sources of data, surveys and information, we identified a suite of sites of waterbird conservation significance in China, following the Ramsar Site Criteria/Important Bird and Biodiversity Area (IBA) Criteria. In total, we identified 422 sites, of which the existing 286 IBA sites formed the basis of the site safeguard network. Altogether, these sites of waterbird conservation significance constitute over 727,000 km2 (7.6% of China’s land surface). Over half of the area of these sites is outside China’s national nature reserves, thus confirming the importance and urgency of including them in the EPRL for the effective conservation of waterbird sites. We suggest that this assessment of sites of waterbird importance offers a useful model to apply to other taxa, such as terrestrial birds and mammals.