Objective To understand the epidemic situation of visceral leishmaniasis (VL) in China in 2023 to provide scientific evidence for formulating prevention and control strategies. Methods Data on VL cases reported in 2023 was collected from the web-based National Diseases Reporting Information System (NDRIS) operated by the Chinese Center for Disease Control and Prevention. From the collected information, suspected cases, duplicate cases and cutaneous leishmaniasis cases were excluded to establish a database. Descriptive epidemiological analysis of the three-dimensional distribution of VL was conducted using Microsoft Excel 2016 software. Results A total of 299 VL cases were reported in 125 counties across 15 provinces (autonomous regions and municipalities) in 2023, with an incidence rate of 0.02/100 000, showing a 25.1% increase from the year 2022. Among these, 237 cases were of mountain-type zoonotic VL (MT-VL), 7 cases were of desert-type zoonotic VL (DT-ZVL), 1 case was of anthroponotic VL (AVL), and 54 cases were imported cases from non-endemic regions. The reported cases were mainly distributed in Shanxi (114 cases), Henan (54 cases) and Shaanxi (38 cases) provinces, together accounting for 68.9% (206/299) of the total reported cases in China. Of the 125 counties, 74 were endemic counties, reporting 245 locally acquired cases, while the remaining 51 were non-endemic counties, reporting 54 imported cases. Among the 74 endemic provinces, seven counties including Pingding County, Suburb District of Yangquan, Xiangfen County in Shanxi Province, Jingxing County of Hebei Province, Huazhou District in Shaanxi Province, Linzhou City and Xin’an County of Henan Province were the major endemic counties. These counties reported 24, 16, 10, 13, 12, 12 and 10 VL cases, respectively, accounting for 32.4% (97/299) of the total cases reported nationwide. Eighteen counties, including Hongdong, Licheng, Linxian, Shilou, and Wutai counties in Shanxi Province; Quyang, Fuping, Laiyuan, Pingshan, Shexian, Tangxian, and Yixian counties in Hebei Province; Songxian and Yuzhou in Henan Province; Chengxian and Kangxian counties in Gansu Province; Yanqing District in Beijing; and Chengcheng County in Shaanxi Province, were new reemergence VL endemic counties, reporting 23 locally acquired cases. The peak incidence of VL occurred in March. The ratio of male to female cases was 1:0.4. Farmers accounted for 57.2% (171/299) of the total cases. The age distribution of VL cases was predominantly in the 45-74 years old group (64.5%). Conclusion VL in China exhibits a low prevalence but the incidence showed a rapid increasing trend, and the endemic area was in expanding. Farmers are recognized as the high-risk population for visceral leishmaniasis. It is imperative to strengthen the surveillance and prevention of visceral leishmaniasis.