Drought is one of the most destructive natural disasters in China and can cause serious environmental and socio-economic impacts. Based on monthly precipitation and temperature data from 571 meteorological stations, the Standardized Precipitation Evapotranspiration Index (SPEI) was calculated on a 12-month scale (SPEI-12) from 1985 to 2018 in mainland China, and it was compared with the records of the Bulletin of Flood and Drought Disasters in China to verify its drought monitoring accuracy. Then, run theory was used to explore in depth the spatiotemporal distribution of drought characteristics and trends in various climatic sub-regions. The results showed that: (1) the comparison with the Bulletin of Flood and Drought Disasters in China indicated that the results of SPEI-12 monitoring drought had high accuracy and could identify drought events in mainland China. (2) About 70% of the regions in mainland China experienced droughts more than 50 times, and about 43% of the regions had drought durations of between 100 and 110 months. Nearly 11% of the regions had drought severities of more than 130, which were mainly located in the Northwest Desert (NWC), the southern part of Northeast China (NEC), and the western part of North China (NC). (3) In the past 34 years, the droughts in the Northwest Desert (NWC), the western part of Inner Mongolia (IM), and the Qinghai-Tibet Plateau (TP) showed an aridity trend, while the droughts in South China (SC) and eastern Central and South China (CSC) presented a mitigation tendency. (4) Specifically, the droughts in South China (SC) were more influenced by precipitation, while those in the Northwest Desert (NWC) and Northeast China (NEC) were influenced by temperature and potential evapotranspiration, and the evolution of drought in North China (NC) and the Qinghai-Tibet Plateau (TP) was mainly influenced by soil moisture. The study could provide scientific guidance and a reference for drought response and sustainable development in China.