Background: This study was conducted to compare the measurement properties of both the EQ-5D-3L and EQ-5D-5L in quantifying health related quality of life (HRQoL) burden for 4 different health conditions in China.Methods: A total of 500 participants from China were recruited to complete the 3L and 5L questionnaire via Internet. The 3L and 5L were compared in terms of distribution properties, ceiling effects and relative efficiency. Distributions of responses were also examined. Results: Ceiling effects decreased significantly in the 5L in all domains (P＜0.01), especially in the pain/discomfort dimension (relative difference: 43.10%). Relative efficiency suggested that 5L had a higher absolute discriminatory power than the 3L version between perfectly healthy participant and 4 condition groups, especially for the HIV/AIDS group when the 3L results was not significant. 5L also had smoother and less clustered index value distributions. Conclusions: Both the 3L and 5L are demonstrated to be valid HRQoL instruments for quantifying disease burden in China. The 5L system may be preferable to the 3L, as it demonstrated superior performance with respect to lower ceiling effect, better relative efficiency and distributions.