ObjectiveTo analyze the trends in the disease burden of gallbladder and biliary tract cancer (GBTC) and the quality of care index (QCI) in China from 1990 to 2023, so as to provide references for targeted prevention and control. MethodsData from the Global Burden of Disease 2023 (GBD 2023) were used to extract indicators including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC, and the QCI was established. Joinpoint regression and age-period-cohort models with Wald test were adopted for trend analysis. The autoregressive integrated moving average model was applied to predict the changing trends from 2024 to 2035. ResultsCompared with the levels in 1990, the numbers of incident cases, prevalent cases, and deaths of GBTC in China in 2023 increased by 136.6%, 213.7%, and 82.8%, respectively; while DALYs, years lived with disability, and years of life lost increased by 52.8%, 151.8%, and 51.9%, respectively. The QCI for GBTC in China increased in the overall population and by gender (female and male), with increments of 59.90, 54.82, and 63.79, respectively. The age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs rate of GBTC in China all decreased from 1990 to 2023, with cumulative declines of 14.1%, 36.2%, and 40.8%, respectively; however, the age-standardized prevalence rate increased, with a cumulative increase of 19.8%. The age-period-cohort model analysis showed that age effects were statistically significant for crude incidence, crude prevalence, crude mortality, and crude DALYs rates (all P<0.01), while period and cohort effects were statistically significant only for crude DALYs rate (P<0.01). From 1990 to 2023, the crude incidence, prevalence, and mortality rates of GBTC in China fluctuated upward. These metrics are projected to continue rising, reaching 3.91, 6.15, and 2.66 per 100 000, respectively, by 2035. In contrast, the crude DALYs rate trended downward and is expected to decline slightly, stabilizing at approximately 51.74 per 100 000 during 2024–2035. The QCI also followed a fluctuating upward trajectory, with a projected further increase to 88.67 by 2035, with gender differences between males and females. ConclusionsThe absolute disease burden of GBTC in China increased continuously from 1990 to 2023. All age-standardized rates declined except the age-standardized prevalence rate, while care quality improved substantially. These trends suggest that, against the backdrop of population aging, sustained efforts are needed to strengthen prevention, control and standardize diagnosis and treatment in the future.