After the start of the First Sino-Japanese War, "Matsushima" was the flagship of Admiral Itō Sukeyuki. She played a central role in the Battle of the Yalu River, as a part of the Japanese main body with "Hashidate", "Chiyoda" and "Itsukushima". During the battle, the shortcomings of her design soon became evident - she was able to fire her Canet gun only four times, knocking out one of the guns on the . During the battle, one of the 259-mm shells from "Pingyuan" struck "Matsushima" in her unarmored starboard side, destroying her torpedo tubes, and killing four crewmen, but the shell failed to explode. However, two of the 305-mm shells from the ironclad also struck "Matsushima". One failed to detonate, and passed through both sides of the hull. The other exploded, destroying the No.4 120-mm gun on the gun deck as it was being loaded, killing 28 crewmen and wounding 68 others. The fire from this explosion knocked three other guns out of commission, and only the quick action by a non-commissioned officer who stuffed his uniform into cracks in a bulkhead prevented the fire from spreading to an ammunition magazine. "Matsushima" also took numerous hits from smaller caliber artillery, damaging her smokestack, masts, and deck equipment, forcing her withdrawal from combat. In all, "Matsushima" lost 57 men (including three officers) and 54 wounded (including four officers) in the battle – more than half of the Japanese casualties during the entire battle. Admiral Itō was forced to transfer his flag to "Hashidate" as "Matsushima" returned to Kure Naval Arsenal for repairs.