Objective To explore the long-term trends and epidemiological characteristics of the disease burden of tetanus in China over the past 30 years and to predict its disease burden in 2050, in order to comprehensively assess the overall disease burden of tetanus in China. Methods Leveraging the methods and findings of the Global Burden of Disease Study 2021, we provided a detailed description of the disease burden of tetanus in China based on key indicators such as prevalence, incidence, mortality, disability-adjusted life years, years lived with disability, and years of life lost due to premature mortality. Joinpoint regression analysis, age-period-cohort analysis, decomposition analysis, and Bayesian age-period-cohort models were employed to further elucidate the epidemiological characteristics of tetanus and predict its disease burden in China by 2050. Results From 1990 to 2021, the overall disease burden of tetanus in China exhibited a significant year-by-year decline. The primary demographic group bearing the burden of tetanus in China had gradually shifted from newborns to middle-aged and elderly individuals, with males being more affected than females. Decomposition analysis indicated that epidemiological change was a significant factor contributing to tetanus in China, while the impacts of population and aging were relatively minor. According to predictions from the Bayesian age-period-cohort model, by 2050, only the prevalence rate was expected to slightly increase, while all other indicators were projected to decline and remain at low levels. Conclusion The disease burden of tetanus in China decreased from 1990 to 2021. In subsequent prevention efforts, newborns and middle-aged and elderly individuals should be prioritized as targets for prevention and control to maintain the disease burden of tetanus at a low level.