Sustainable public procurement (SPP) is an important element of China’s public policy and a market instrument to achieve sustainable development. This research aims at achieving insights into China’s SPP through a nationwide survey of Public Procurement Centers (PPCs), telephone interviews, and an expert workshop. The results show that China’s SPP is a hierarchical and centralized multi-level system, which is characterized by a top-down structure and is mainly driven by legal and policy initiatives, social benefits, and commitments of public bodies. There is huge potential for more SPP that remains untapped in China, and barriers are observed at the SPP operational level. The main barriers include a lack of trust in sustainability information about different products, limitations of the two SPP lists used, a lack of knowledge and skills, the perception of higher prices in the case of SPP, a lack of transparency, a lack of user-friendly tools, and soft social–environmental criteria that have low operability in the local situation. This research recommends a reform of SPP, moving from applying technical and functional specifications from the existing two-list approach to involving state-owned enterprises and infrastructure projects in a different SPP approach. Theoretical conclusions concern the Chinese SPP practice. In China, SPP is more like social responsible public procurement. Secondly, it was found that there are advantages to a more decentralized system, and finally, the implementation of SPP is declining because of specific barriers identified in this study.