Babesiosis is a zoonotic parasitic disease caused by infection with Babesia species, primarily transmitted via tick bites, with blood transfusion, vertical transmission and organ transplantation serving as secondary routes. After infection, Babesia parasites invade and multiply within red blood cells of humans and other vertebrates. Human-pathogenic species include B. microti, B. venatorum, B. divergens, B. crassa-like organisms, B. microti-like species and the novel B. XXB/Hangzhou. As of November 2025, a total of 328 confirmed and asymptomatic cases have been reported across 16 provinces in China, including Heilongjiang, Henan, Yunnan and Guangxi. B. microti is the predominant species in China, frequently identified in regions such as Zhejiang, Yunnan and Guangxi, while B. venatorum and B. crassa-like agents are endemic in Heilongjiang Province in northeastern China, with B. divergens reported sporadically in other regions. Key vectors include hard ticks in the genus Ixodes, such as I. persulcatus and Haemaphysalis longicornis, with small rodents serving as important reservoir hosts. Clinical manifestations range from asymptomatic or self-limiting fever to severe hemolytic anaemia, particularly in immunocompromised individuals who are at higher risk of severe outcomes. Diagnostic methods consist of blood smear microscopy, serological testing, molecular assays and emerging metagenomic sequencing. The first-line treatment is a combination of atovaquone and azithromycin, with quinine plus clindamycin serving as an alternative regimen. Given the emergence of drug resistance and the ongoing improvement of surveillance systems, babesiosis has become a significant emerging infectious disease threat in China.