In 2013, the People's Republic of China and the Republic of Macedonia jointly celebrated the 20th anniversary of the diplomatic ties. The friendly and cooperative relations between the two countries deepened.

Close exchanges were conducted at the top level. In November, Premier Li Keqiang met with President of the Government of Macedonia Nikola Gruevski in Bucharest, Romania on the sidelines of the Meeting of Heads of Government of China and Central and Eastern European Countries. In January, State Councilor and Defense Minister General Liang Guanglie visited Macedonia. In July, President of the Government of Macedonia Gruevski attended the Local Leaders' Meeting of China and Central and Eastern European Countries in Chongqing, China. President Xi Jinping and Premier Li Keqiang met with him. In October, Macedonian President Gjorge Ivanov made a trip to China to attend the 14th Western China International Fair in Chengdu. In Beijing, President Xi Jinping met with him.

Smooth progress was made in business cooperation. In May, Macedonian Deputy Prime Minister Vladimir Peshevski and Minister of Transport and Communications Mile Janakieski attended business events in China. A Chinese enterprise and the Macedonian National Road Company signed business contract on building the Milanovic-Stip Expressway and the Kisevo-Ohrid Expressway in Macedonia.

Exchanges and cooperation in party affairs, science and technology, culture, and security continued to expand. In April, a delegation of the Internal Macedonia Revolutionary Organization attended the fourth China-Europe Political Parties Forum in Suzhou, China. In May, the Third Session of China-Macedonia Committee for Scientific and Technological Cooperation was convened in Macedonia. In July, the first Chinese Cultural Festival was held in Macedonia. In September, the first Confucius Institute in Macedonia was officially launched in St. Cyril and Methodius University. In October, Minister of Internal Affairs Gordana Jankuloska visited China. In December, the China Disabled Peoples' Performing Art Troupe gave performances in Macedonia. By the end of 2013, there were two pairs of sister cities between the two countries.

Macedonia took an active part in the cooperation between China and Central and Eastern European Countries. In May, Macedonian Deputy Minister of Culture Dragan Nedeljkovic attended the Forum on Cultural Cooperation between China and Central and Eastern European Countries in China. In July, Vlado Misajlovski, State Secretary at the Ministry of Foreign Affairs and Macedonia's National Coordinator for China-Central and Eastern European Countries cooperation, accompanied President of the Government Gruevski in attending the Local Leaders' Meeting of China and Central and Eastern European Countries in Chongqing, China, together with a Macedonian local leaders' delegation. In September, Perica Ivanoski, State Counselor of Ministry of Agriculture, Forestry and Water Economy, attended the Workshop on Agriculture Science and Technology Exchange between China and Central and Eastern European Countries and the eighth Agro-trade & Economic Cooperation Forum between China and Central and Eastern European Countries. In October, National Coordinator Misajlovski attended the National Coordinators' Meeting for Cooperation between China and Central and Eastern European Countries in Bucharest, Romania. A delegation of the Internal Macedonian Revolutionary Organization attended the Young Political Leaders Forum of China-Central and Eastern European Countries in China. In December, Macedonian experts and scholars attended the High-level Symposium of Think Tanks of China and Central and Eastern European Countries in China.