On September 11, 1989, the People's Republic of China officially established diplomatic relations with the Federated States of Micronesia(FSM).

In November 2014, President Xi Jinping met with President Emanuel Mori of FSM in Fiji and the two sides upgraded the relations to a strategic partnership featuring mutual respect and common development. In November 2018, President Xi Jinping met with President Peter Christan of FSM in Papua New Guinea and the two sides upgraded the relations to a comprehensive strategic partnership featuring mutual respect and common development. In April 2024, President Wesley Simina of FSM paid a state visit to China. The two sides issued Joint Statement between the People’s Republic of China and the Federated States of Micronesia.

The two countries witnessed headway bilateral cooperation in exchanges and cooperation in areas such as agriculture, fishery, investment infrastructure, development cooperation and etc. The Chinese medical teams have been offering free medical services in FSM since 2024.