This study aimed to evaluate recent trends in physical inactivity prevalence by sociodemographic characteristics and the province of China's residence between 2013 and 2019.The study included 4,229,616 participants aged 40 years or older from 414 geographically defined localities in China during the 7-year period. Self-reported total physical inactivity was collected to determine the standardized prevalence of physical inactivity. Logistic regression analysis was used to examine the association between physical inactivity and stroke risk, obtaining odds ratios (OR) and 95% confidence intervals (CIs).Results showed that the standardized prevalence of physical inactivity increased from 22.12%(95%CI:21.99%-22.45%) in 2013 to 28.79%(95%CI:28.48-29.19%) in 2019, with an absolute difference of 6.67% (95% CI, 6.15% to 7.16%) and a yearly increase rate of 5.03% (95% CI, 4.85% to 5.21%). In 2019, physical inactivity was higher in female and rural participants (female: 29.55%; rural: 29.46%) than in male and urban participants (male: 28.03%; urban: 28.26%). The prevalence of physical inactivity also varied by race/ethnic groups, with the highest prevalence observed among Uyghur (47.21%) and the lowest among Yizu (14.84%). Additionally, the prevalence of physical inactivity differed by province, ranging from 14.44% in Beijing to 50.09% in Tianjin in 2019. Multivariate analyses showed that physical inactivity was associated with a higher risk of stroke (OR = 1.17; 95% CI = 1.12-1.21; P < 0.001).In conclusion, our study found an overall increase in physical inactivity prevalence among Chinese adults aged ≥40 years from 2013 to 2019, with significant variation across regions, sex, ages, and race/ethnic groups.Copyright © 2023 by the American College of Sports Medicine.