This chapter traces the evolution of startup ecosystems in mainland China, from the “Reform and Opening-Up” era to the present day. It begins with a historical overview, examining China’s transition from a state-dominated economy to a vibrant, market-oriented landscape. This shift was driven by the pivotal policies like the “Torch Plan”, the rise of university-industry collaboration, and the influence of “returnee” entrepreneurs. The chapter then analyses the transformative impact of the 2014 “Mass Entrepreneurship and Innovation” initiative on funding, infrastructure, and cultural attitudes. Through a comparative analysis of four major innovation hubs—Beijing, Suzhou, Chongqing, and Shenzhen—it explores the similarities and the unique advantages, policy approaches, and industrial specialisations of each city. Ultimately, this chapter offers crucial insights for policymakers aiming to foster sustainable growth and for entrepreneurs navigating China’s dynamic startup landscape.