Chapter 4 critically examines the interplay between China’s pharmaceutical industry, Traditional Medical Knowledge (TMK), and the country’s evolving Intellectual Property (IP) governance framework. It highlights the historical, socioeconomic, and cultural factors shaping China’s IP system, which, while adopting Western-inspired standards, prioritises national interests and reflects the dialectical thinking embedded in Chinese traditions. The analysis reveals systemic biases within the IP framework that disproportionately favour corporate actors, often at the expense of TMK holders and local communities. This chapter explores China’s historical achievements in pharmaceuticals, the role of TMK in shaping the industry, and the government’s efforts to modernise the sector. It uncovers how policies prioritising corporate interests have facilitated the exploitation of TMK, sidelining its cultural and community-based value. Furthermore, the influence of pharmaceutical corporations in shaping IP laws underscores structural inequalities and power imbalances within the system. Key issues, including the patentability criteria, novelty, inventiveness, and disclosure of origin requirements, are critically analysed to demonstrate how these elements often favour corporate appropriation of TMK. This chapter calls for comprehensive reforms, proposing changes to patentability criteria that incorporate Confucian principles of social welfare, environmental sustainability, and societal harmony. It advocates for enhanced disclosure of origin requirements, statutory exclusions for TMK-based inventions, and the establishment of a central authority to protect TMK holders’ rights. By integrating China’s cultural and historical context into legal reforms, this chapter envisions an IP regime that balances innovation with the preservation of TMK’s intrinsic value. However, it concludes that IP laws alone may not suffice, emphasising the need for complementary mechanisms to ensure the comprehensive protection and sustainable utilisation of TMK.