Much has changed in US-China relations since the first edition of this book over a decade ago alerted readers to balance outwardly positive discourse in multiple bilateral dialogues with an understanding of important differences. This fourth edition provides a comprehensive assessment of historical and contemporary determinants of Sino-American relations up to the present, giving special focus to the recent dramatic hardening amid acute competition between the world's leading powers. The catalyst and main driver of this negative change remains a unique bipartisan Congressional-Administration consensus that sees multiple challenges from China now posing an overall existential threat. Urgency to counter these challenges dominates US policy making toward China. The consensus came about despite acute partisanship and erratic presidential leadership during the Trump administration and it continues strong with the more consistent foreign policy of President Biden. China remains uncompromising, forecasting continued trouble ahead. Leading expert Robert G. Sutter has written the only book on the subject that combines assessment of the historical evolution, in-depth analysis of the many issues determining recent developments, and likely prospects for US-China relations going forward. His balanced study will be an essential resource for all concerned with the globe's most crucial bilateral partnership.