This study provides a systematic overview of the advent and evolution of reliability systems engineering (RSE) in China, and the latest RSE development, that is, model-based RSE (MBRSE), is emphatically introduced. The establishment of the system architecture and conceptual models of MBRSE is first described. The fundamental theory and methodology of MBRSE are then elaborated, with a V-model as the core of this approach. The development of various MBRSE platforms and the effectiveness of their implementation over the past 30 years are presented. The prospective trends in the development of RSE in China are outlined.