We set out to assemble this special issue of IJPP with three goals in mind: (1) to familiarize Anglophone readers with research on paleopathology conducted by Chinese scholars; (2) to enhance interest in paleopathological research among Chinese scholars, and to foster the use of differential diagnosis as the key mode of paleopathological analysis; and (3) to initiate integration of pathological analysis of human skeletal collections with historical records documenting early medical practices, epidemics, development and age-related diseases, and demographic records. The collection of papers that follows present new data, from a range of time periods and geographic and social contexts, that we feel reflect the diversity, dynamism, and enormous scope of archaeology in China today. Themes such as infectious disease history, interpersonal violence, and comorbidity as a methodological issue are addressed by multiple papers. However, as the special issue developed, we also came to a slow appreciation of structural constrains that made our original goals difficult to attain within the current state of our discipline, of which the language barrier represents only a minor issue. The following sections are intended to contextualize this special issue, and help readers understand the intrinsic and extrinsic factors that influence paleopathological research in China and its interactions with similar research in other parts of the world.