PurposeAssessing the efficiency of fresh food cold chain logistics as accurately as possible is essential for industry development planning. This study was designed to analyze the efficiency of fresh food cold chain logistics in China.Design/methodology/approachA three-stage data envelopment analysis (DEA) model was used to analyze the efficiency of fresh food cold chain logistics in 30 provinces of China from 2013 to 2019. The stochastic frontier analysis (SFA) model in the second stage was used to eliminate the influence of external environmental factors and random disturbances on efficiency analysis results.Findings(1) The overall actual efficiency of fresh food cold chain logistics in China is unsatisfactory, with an average technical efficiency of 0.382 over the 7-year period. (2) The national average technical efficiency and average scale efficiency were overestimated by 29.9% and 40.0%, respectively, compared with the actual values. (3) The efficiency of fresh food cold chain logistics does not align with the level of regional economic development. (4) Distinct regional variations exist in the efficiency of fresh food cold chain logistics in China, with higher efficiencies observed in Northwest China and the Central Yangtze River regions, and the lowest efficiencies in the northeast regions.Originality/valueThis study applies a three-stage DEA model to assess the development and regional differences of fresh food cold chain logistics in China, enriching the application of models and empirical analysis in this field. By analyzing the situation in China, it provides ideas and references for other developing countries to develop cold chain logistics.