Background <p>The COVID-19 pandemic has a significant impact on global mental health. In China, men who have sex with men (MSM) faced more challenges and experienced psychological distress due to social and cultural factors. The pandemic has further exacerbated their situation. However, few studies have examined mental health and coping strategies among Chinese MSM in the post-COVID era.</p> Methods <p>A semi-structured interview was conducted with 32 Chinese MSM participants to discuss stress and coping in the post-COVID era. Participants were recruited online. Thematic analysis was used to analyse the data to identify key patterns and themes regarding stressors and copings.</p> Results <p>It was found that Chinese MSM faced multiple stressors, including economic instability, family expectations, and digital overload. Coping strategies included emotional minimalism or active engagement in daily life. Financial independence and supportive connections were identified as protective factors. However, the legal invisibility of same-sex relationships and the homophobic content on online platforms still affected their mental health.</p> Conclusions <p>This study explored the challenges faced by MSM in China post-COVID, increasing the understanding of the mental health challenges faced by this group. There is a need for culturally competent mental health services. Mental health professionals should provide culturally appropriate mental health services and support to improve the well-being of MSM in the post-COVID era.</p>