Objective To analyze the endemic status and epidemiological characteristics of visceral leishmaniasis in China from 2004 to 2016, so as to provide basis for the formulation of prevention and control strategies. Methods The data for the visceral leishmaniasis endemic in China from 2004 to 2016 were collected from Infectious Disease Reporting Management System of China Center for Disease Control and Prevention(CDC) and analyzed by Microsoft Excel 2016. For those cases reported in non-endemic areas, the infection information will be confirmed and verified by the local provincial CDC. Results A total of 4 448 cases of visceral leishmaniasis were reported in 24 provinces (municipalities or autonomous regions) in China from 2004 to 2016, with specific case number of 306, 311, 270, 355, 518, 523, 375, 300, 219, 158, 293, 510 and 310 cases for each year, respectively. The visceral leishmaniasis cases were reported throughout the year, but the peak was among October to November in Jiashi endemic county and among March to May for the rest of endemic areas. Total 98.1% (4 364/4 448) of the reported cases came from endemic areas, mainly from Xinjiang （including Xinjiang Production and Construction Corps）, Gansu and Sichuan provinces which account for 95.6% of the reported cases nationwide. Only 84 cases of visceral leishmaniasis were reported in 17 non-endemic regions, accounting for 1.9% of the reported cases. The visceral leishmaniasis endemic areas were located in 83 counties in 7 provinces or autonomous regions, among them 46 endemic counties located in Xinjiang Autonomous Region. The case reported counties are increased from 43 in 1990 to 83 in 2016, with reemerging areas in Linzhou, Wushi and Shache counties in Henan province. Total 12 visceral leishmaniasis cases were reported in non-endemic areas in 2016, all were confirmed to be imported cases. Among the total reported cases, 2 712 were male and 1 736 were female with a ratio of male to female to 1.6:1. The average age of reported cases was 12.3, mainly under 5 years old which accounts for 54.9% of total cases. Children and farmers were the most vulnerable population for visceral leishmaniasis which account for 72.6% of reported cases(3 228/4 448). Conclusion Visceral leishmaniasis endemic is sporadic in the middle western areas of China, with sporadic outbreaks and reemergence in some areas. The reported cases are decreasing except for those outbreak areas, but the endemic areas is growing.