This chapter critically examines the establishment and implementation of an Access and Benefit-Sharing (ABS) mechanism for Traditional Medical Knowledge (TMK) in China, exploring the interplay between international ABS frameworks and China's unique cultural, historical, and legal contexts. It highlights the challenges posed by cultural differences in understanding concepts like prior informed consent (PIC) and benefit-sharing, which are rooted in Western ideologies yet must be applied within China’s communal and Confucian value systems. This chapter outlines China's historical attitudes towards knowledge sharing, shaped by egalitarian and Confucian principles that emphasise collective welfare and open access over exclusive rights. It critiques the compensatory model proposed in China’s Draft ABS Regulation, suggesting it is inconsistent with traditional Chinese values and proposing a shift towards multilateral frameworks focused on public interest and societal harmony. Through an analysis of China's legislative progress, including the Draft Regulation and associated policy frameworks, this chapter explores the complexities of aligning international ABS obligations with China’s governance structures. It highlights the importance of nuanced definitions and culturally relevant mechanisms for ABS implementation, such as incorporating concepts like Yuan shengtai to reflect China's unique sociocultural values. This chapter concludes by advocating for an innovative, culturally sensitive ABS framework that integrates international norms with China's traditions, fostering equitable benefit-sharing and sustainable management of TMK. This approach seeks to balance global obligations with local realities, ensuring the protection, utilisation, and dissemination of TMK while contributing to global efforts in biodiversity conservation and traditional knowledge governance.