Purpose <p>Understanding the current status of a discipline is crucial for its robust and progressive development. In 2018, the first nationwide survey of Chinese anesthesiology provided critical insights into workforce distribution, patient outcomes, infrastructure, and educational resources. Given the dynamic nature of the discipline and the rapidly changing healthcare landscape, a follow-up survey was deemed essential to capture the current status of Chinese anesthesiology.</p> Methods <p>This second round cross-sectional nationwide census survey was conducted from February 1, 2022, to August 31, 2022. Participants comprised each hospital department providing anesthesia services across the 31 provinces of mainland China. Data analysis was performed from January 2023 to January 2024. The survey content remains consistent with inaugural study, including general information of the department, hospital level and scale, volume of the anesthesiology department, characteristics of anesthesiologists, and anesthetic caseloads. Data were collected and uploaded using face-to-face interview conducted by trained interviewers. Data quality was controlled by electronic questionnaire and continuous oversight by the investigation committee throughout the whole process.</p> Results <p>The nationwide census survey, conducted among 11,505 hospital departments providing anesthesia services in China, identified a total workforce of 105,732 anesthesiologists. This represents a 14% increase in the number of anesthesiologists over the preceding five-year period. The national anesthesiologist-to-population ratio was calculated at 7.5 per 100,000 individuals, with regions boasting higher gross domestic product per capita exhibiting a higher density of anesthesiologists. Additionally, the survey documented 25,056 anesthesia nurses contributing to the anesthesia workforce. Analysis of anesthesiologists' workload indicated a compound annual growth rate of 2.72% from 2018 to 2020. Notably, non-operating room anesthesia cases demonstrated a growth rate approximately 7% higher than that of operating room anesthesia cases, suggesting a discernible shift in clinical practice patterns.</p> Conclusions <p>Chinese anesthesiology has experienced rapid growth, underscored by the substantial expansion in its workforce. Nevertheless, persistent challenges necessitate ongoing attention. The findings derived from this nationwide survey provide critical insights for guiding the discipline’s future development and informing evidence-based policy-making.</p>