The People’s Republic of China is an important player in international markets for animal products, antibiotics, as well as in global efforts to combat antibiotic resistance (AMR). This paper reviews use of antibiotics and the emergence of AMR in Chinese food animal production. The rapid growth in food, animal production, and the relatively poor animal production conditions as well as increasing production intensity led to a sharp increase in antibiotic use in both absolute and relative terms. This trend, however, has been reversed by recent government policies and public awareness of AMR. Four government policies are particularly important in attempting to decrease the use of antibiotics: the imposition of maximum residue levels, establishing a list of permitted antibiotics, the proper use of antibiotics during the withdrawal period, and establishing a list of prescription-only antibiotics use in animal production. Antibiotic use in China is more than five times higher than the international average. One of the main reasons for the relative higher antibiotic usage is the widespread misuse associated with growth promotion in the feed and veterinary use on broiler and pig farms. The relatively low cost of antibiotics, estimated at 1% to 3% of production costs, encourages such excess use in livestock production, but alternatives are often not available and more costly. This paper recommends a mix of economic and regulatory approaches to control the overuse of antibiotics in livestock production and limit the rise in antimicrobial resistance.