Background <p>Following the outbreak of the coronavirus disease (COVID-19) in 2019, there was a lack of systematic data on the disease burden and epidemiological trends of respiratory infections in China.</p> Methods <p>A systematic analysis of the 2021 Global Burden of Disease Study was conducted to estimate the incidence, mortality, and disability-adjusted life years of upper respiratory infections (URIs) and lower respiratory infections (LRIs) in China. These estimates were stratified according to sex and age. A joinpoint regression model was used to assess the trends in the incidence and mortality of URIs and LRIs in China from 1990 to 2021. The Age-Period-Cohort model was used to calculate the contributions of age, period, and cohort effects to the morbidity and mortality risks of URIs and LRIs in China over the observation period.</p> Results <p>In 2021, the age-standardised incidence rates for URIs and LRIs were 137,469 per 100,000 and 2,853 per 100,000, respectively, representing a decrease of 0.03% and 2.12%, respectively, from 1990. Furthermore, 2,193 deaths from URIs and 206,930 deaths from LRIs were noted in 2021. For URIs, the DALYs decreased from 1,426,557 in 1990 to 649,505 in 2021; for LRIs, they decreased from 32,576,310 in 1990 to 4,106,779 in 2021. The URI and LRI burdens were slightly higher in males compared with females, and they were relatively higher in neonates and the elderly. The incidence and mortality rates of URIs and LRIs were significantly influenced by age, period, and birth cohort.</p> Conclusion <p>The disease burden of respiratory infections in China exhibited a declining trend from 1990 to 2021. However, the risk of infection increased with age, highlighting the need for continued research and development of targeted measures to prevent respiratory infections.</p>