The goal of a new study published in BMC Gastroenterology was to estimate the morbidity, distribution, and burden of self-reported acute diarrheal illness (ADI) in China over the last three decades. This study entailed a search from Pubmed/Medline, Embase, and Cochrane Library databases. Articles published before Dec 31, 2014 were included; data were extracted and the pooled 2-week incidence rate of ADI was calculated. The findings revealed that the pooled 2-week prevalence of ADI in the country was 2.04% and the corresponding incidence rate was 0.53 episodes per person-year. The ADI rate was highest among children below 5 years of age, and was slightly higher among males. There was a significant decrease in the incidence of ADI from 1980 to 2012, but the incidence remained consistent in the last two decades. Furthermore, the incidence of ADI was found to be higher in rural areas and in west China and peaked in the summer months. The results of this study indicated that ADI caused a substantial disease burden in the last 30 years, especially in the rural areas and western regions of the country, where sanitation conditions were relatively poor.