Environmental flows (e-flows) are important for river protection and restoration under degraded ecological conditions. With increasing public desire for and pursuit of sustainable development, e-flows are widely used to reflect the hydrological regime requirements for sustaining freshwater ecosystems and human livelihoods. Over the past 40 years, e-flows implementation has shifted from static minimum flows to dynamic flow components. However, e-flows standards used to manage flow releases from dams are to a great extent based on expert judgement and government supervision. These attributes make it difficult to effectively implement e-flows in the non-stationary world. The primary focus of this paper is to review the history, management systems and scientific basis of e-flows in China. Firstly, the study classifies the development phases into four periods and then analyses the underpinning legal system for e-flows implementation in each period, including the laws, regulations, policies and responsible authorities. Finally, the scientific basis and methods for e-flows determination and assessment were analyzed. The study showed that: (1) e-flows have been officially regarded as ecological flow in China, which evolved from minimum flow, and the contents and connotations are still broadening; (2) currently, there are too many authorities related to e-flows and complicated legal documents in China which lead to ineffective implementation; (3) the scientific basis of e-flows is enriched from the relationship between hydrological alteration and ecological response, so that the practices will be more holistic in China. Despite the successful practices of e-flows implementation in large rivers, there are challenges for implementing future e-flows in small rivers. This study recommended that future e-flows implementation be integrated with sustainable water management by setting clear responsibilities for governments, ministries, and other stakeholders.