Demand for sugar is projected to grow in China for the foreseeable future. However, sugarcane production is unlikely to increase due to increasing production cost and decreasing profit margin. The persisting sugarcane yield plateau and the current cropping system with fertilizer overuse, soil acidification and pests and diseases remain the major productivity constraints. Sugarcane agriculture supports the livelihood of about 28 million farmers in South China; hence, sustaining it is a socioeconomic imperative. More compellingly, to meet the ever-increasing Chinese market demand, annual sugar production must be increased from the current 10 Mt to 16 Mt by 2030 of which 80% to 90% comes from sugarcane. Therefore, increasing sugar yield and crop productivity in an environmentally sustainable way must be a priority. This review examines the current Chinese sugarcane production system and discuss options for its transition to a green, sustainable cropping system, which is vital for the long-term viability of the industry. This analysis shows that reducing chemical inputs, preventing soil degradation, improving soil health, managing water deficit, provision of clean planting material, and consolidation of small farm holdings are critical requirements to transform the current farming practices into an economically and environmentally sustainable sugarcane cropping system.