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Identifying strategies to maintain seafood supply is central to global food supply. China is the world’s largest producer of seafood and has used a variety of production methods in the ocean including domestic capture fisheries, aquaculture (both freshwater and marine), stock enhancement, artificial reef building, and distant water fisheries. Here we survey the outcomes of China’s marine seafood production strategies, with particular attention paid to the associated costs, benefits, and risks. Benefits identified include high production, low management costs, and high employment, but significant costs and risks were also identified. For example, a majority of fish in China’s catches are one year-old, ecosystem and catch composition has changed relative to the past, wild and farmed stocks can interact both negatively and positively, distant water fisheries are a potential source of conflict, and disease has caused crashes in mariculture farms. Reforming China’s wild capture fisheries management toward strategies used by developed nations would continue to shift the burden of production to aquaculture and could have negative social impacts due to differences in fishing fleet size and behavior, ecosystem structure, and markets. Consequently, China may need to develop novel management methods in reform efforts, rather than rely on examples from other large seafood producing countries. Improved accounting of production from fisheries and aquaculture, harmonization and centralization of historical data sets and systematic scientific surveys would improve the knowledge base for planning and evaluating future reform.