Abstract: China currently has over 94 000 reservoir dams. Since the beginning of the 21st century, China has maintained an excellent dam safety record, becoming one of the countries with the lowest dam failure rates in the world. In the context of accelerating urbanization and intensifying climate change impacts, coupled with increasingly dense populations and infrastructure downstream of reservoirs, the safety risk landscape for dams and their downstream protected assets has undergone a fundamental transformation. Over the past two decades, China’s dam safety management has undergone a fundamental transition from an engineering safety approach to a risk management-oriented strategy. This shift is the result of continuous exploration and practice in the field. This paper systematically reviews the development of dam risk management in China, tracing its evolution from the introduction of international concepts to the establishment of a localized system. It emphasizes significant technological advancements in the domains of risk identification and assessment, standard development, and prevention and response measures. Additionally, it delineates innovative practices, exemplified by the integrated intelligent risk perception system, the risk assessment standard framework, the digital twin platform, and the modern operational management matrix. The integration of these components establishes a comprehensive, end-to-end risk prevention and control technological system. This system provides essential support for ensuring the long-term dam safety and downstream public safety.