This chapter explores the challenges of integrating China’s traditional medical knowledge (TMK) within the predominantly Western framework of intellectual property (IP) rights. It examines the historical, cultural, and philosophical underpinnings of TMK and its inherent tension with IP systems that prioritise individual rights and commercialisation. By tracing the evolution of IP rights and their transplantation into China, this chapter reveals the cultural conflicts and administrative barriers that hinder the effective protection of TMK. It also evaluates China’s engagement with international IP agreements and the efforts to mandate disclosure requirements for genetic resources and TMK. A critical analysis highlights the mismatch between the Western IP system and TMK, which is rooted in collective ownership and cultural heritage. This chapter underscores how Confucian principles and the communal nature of TMK challenge the application of Western IP norms. Drawing on these insights, this chapter proposes a tiered approach to TMK protection, offering differentiated rights based on the diffusion and nature of the knowledge. This tailored model aims to safeguard TMK while promoting its responsible use and preserving its cultural significance. Ultimately, this chapter advocates for a culturally sensitive IP framework that bridges the gap between global IP standards and China’s unique TMK system. By addressing the complexities of TMK regulation, this chapter contributes to the broader discourse on reconciling traditional knowledge with contemporary legal frameworks, fostering innovation, and protecting cultural heritage.