The 28 December 2006 execution of Qiu Xinghua after his trial for killing eleven persons and injuring two highlights the need for insanity law reform in China. This editorial chronicles matters suggestive of Qiu Xinghua having suffered symptomatology of a serious psychiatric illness around the time of his commission of the homicides. Although as of 1 January 2007, China has put in place review processes in relation to capital convictions as a result of pressures from human rights campaigns, there is an urgent need for lawyers and mental health experts internationally to lobby China to reform its criminal law in relation to the responsibility of persons with serious mental illnesses.