BackgroundThe recent increase of group AStreptococcus(GAS) infections in Europe has aroused global concern. We aim to provide molecular biological data for GAS prevention and control in China by analyzing the temporal shift ofemmtype.MethodsWe collected studies reporting GASemmtypes in China from 1990 to 2020 by PRISMA statement and established a summary database includingemmtypes and literature quality assessment. Based on the database we analyzed the geographic distribution ofemmtypes from 1990 to 2020 and assessed the coverage of the known GAS 30-valent vaccine. Outbreak-associatedemmtypes that had been reported over the past 30 years were also included.Results47 high quality studies were included for a systematic analysis ofemmtype distribution. This generated a database including totally 12,347 GAS isolates and 85emmtypes. Shift of dominantemmtype was witnessed during the past 30 years in China. In mainland China, dominant types changed fromemm3,emm1,emm4,emm12 in 1990s toemm12 andemm1 in 2000s and 2010s. Hong Kong and Taiwan were dominated byemm12,emm4 andemm1, of whichemm4 reduced butemm12 increased in 2010s significantly. From 1990 to 2020, newly foundemmtypes were increasingly reported in various regions of China. The reported 30-valent M protein vaccine covered 26 M types prevalent in China, including all dominant types.