Neonicotinoid pesticides (NEOs) were initially considered viable alternatives to conventional organo-pesticides extensively used in agriculture, horticulture, and households. However, the increased frequency and concentration of NEOs in waterways have drawn significant attention and concern due to the resulting threats to ecosystems and public health worldwide. The demand for monitoring NEOs in water has led to numerous efforts in many countries and regions. Given occurrence and distribution of these pesticides/insecticides. This study reviews NEOs monitoring in China from 2019 to 2022, aiming to gather and analyse information on China’s efforts in NEOs monitoring to provide reference for future research. The study primarily focuses on the southern and southeastern regions of China, specifically on lakes and tributaries of rivers, including Taihu Lake, Pearl River, Yangtze River, Songhua River, and Liao River. This focus can be attributed to the prioritisation and environmental demands related to the local economic status and major developmental tasks. The evaluation of the corresponding ecological risks of human exposure to NEOs ranged from low to medium-high levels. However, despite these findings, contamination from NEOs is still considered to lack sufficient attention and concern. Additionally, the presence of NEOs in other environmental media, such as indoor dust, wheat grains, vegetables, and teas, requires close attention in the future.