Leukemia is a major public health problem in China, but epidemiological studies on leukemia in China are still insufficient. This study aims to analyze leukemia's disease burden and risk factors in China from 2010 to 2021 and provide a basis for leukemia prevention and treatment. Using data from the Global Burden of Disease (GBD) database, trends in the burden of leukemia in China from 2010 to 2021 were analyzed. Additionally, epidemiological differences by gender and age groups were explored. In 2021, there were 531,000 leukemia patients in China, with 106,000 new cases and 59,000 deaths. Compared to 2010, the mortality rate and disability-adjusted life years (DALYs) per 100,000 population in 2021 decreased by 5% and 18%, respectively, while the incidence and prevalence rates increased by 12% and 29%, respectively. Gender and age stratification indicated that males had higher rates across all indicators than females, and elderly individuals faced higher leukemia mortality and DALYs. The most significant decrease in DALYs was observed in children and adolescents under 20. The highest burden of leukemia for males was found in the 85–90 age group, while for females, it was in the 70–74 age group. Major risk factors for leukemia included smoking, high BMI, and exposure to carcinogens, benzene, and formaldehyde. The overall burden of leukemia in China showed a decreasing trend, with significant gender and age differences. More measures are needed to reduce leukemia mortality, particularly focusing on the prevention and treatment of leukemia in males and the elderly.