The production of sewage sludge is increasing in China but with unsafe disposal practices, causing potential risk to human health and the environment. Using literature from the past 30 years (N = 159), we conducted a meta-analysis of organic contaminants (OCs) in Chinese sludge. Most data were available from developed and populated regions, and no data were found for Tibet. Since 1987, 35 classes of chemicals consisting of 749 individual compounds and one mixture have been analyzed, in which antibiotics and polycyclic aromatic hydrocarbons (PAHs) were the most targeted analytes. For 13 classes of principal OCs (defined as chemicals detected in over five studies) in sludge, the median (expressed in ng/g dry weight) was the highest for phthalate esters (27,900), followed by alkylphenol polyethoxylates (12,000), synthetic musks (5800), antibiotics (4240), polycyclic aromatic hydrocarbons (3490), ultraviolet stabilizers (670), bisphenol analogs (160), organochlorine pesticides (110), polybrominated diphenyl ethers (100), pharmaceuticals (84), hormones (69), perfluorinated compounds (21), and polychlorinated biphenyls (15). The concentrations of PAHs in samples taken since 1998 featured a decreasing trend. Study findings suggest the need for a Chinese national sludge survey to identify and regulate toxic OCs, ideally employing both targeted as well as non-targeted screening approaches.