Anthropogenic activities are substantially changing coastal wetland ecosystems globally. In developing countries such as China, a number of anthropogenic factors associated with rapid population growth and economic development threaten coastal wetlands. In China, notably, coastal wetlands have been increasingly lost to reclamations that are widely adopted to meet the increasing demand for land under rapid economic development. Coastal wetland management requires understanding the patterns of and the mechanisms underlying such human impacts. In this special issue, we synthesize current understanding of environmental changes and human impacts on China’ coastal wetlands, focusing on reclamation. Coastal human activities in China are found to change shoreline evolution and wetland hydrology, to deteriorate soil and water quality, to alter vegetation succession, benthic animal and microbial communities, and fisheries, and to impair ecosystem functioning and services. For some of those impacts, new models and indices are developed or applied. We also outline key research areas that should be further studied for effective management of coastal wetlands and successful wetland restoration. We suggest that developing a multi-objective, multi-scenario, and multi-scale framework of integrated management will be crucial to the success of China’s coastal wetland conservation with increasing human dominance of the nation’s coasts.