Objective: To study the current status and operational mechanisms of health technology assessment in China. Methods: Combining complex adaptive system theory，the tag，internal model and building blocks mechanisms of health technology assessment implementation were analyzed. Results: Based on the tag mechanism，the policy environment for health technology assessment in China was good，while the institutional system and talent system at the local level were still immature; based on the building block mechanism，different entities had different tools in the process of health technology assessment implementation，while the methodological guidelines and process framework were not authoritative and transparent; based on the internal model mechanism，the needs and expectations between the demand side and the supply side of health technology assessment，resulting in research findings not being translated into policy implementation. Conclusion: Health technology assessment is a complex adaptive system that involves interactions between multiple stakeholders and the interactions between subjects and the environment，and requires systems thinking to further reconfigure implementation mechanisms.