Worldwide, China has the largest district heating (DH) area and is also the fastest growing country. This paper presents field measurement results for operational energy consumption from 38 DHSs to fill in the gaps in understanding of the current operational issues of the district heating system (DHS). The average heat consumption during the heating period was 98.6 kWh/m² and the monthly average electricity consumption for circulating pumps in the primary and secondary networks was 0.27 kWh/(m² × month) and 0.29 kWh/(m² × month), respectively. Thereafter, a systematic method for breaking down the energy consumption and quantitatively evaluating the underlying problems is presented. Based on several detailed measurements conducted in typical heat-exchange substations (HESs), it was found that overheating was the most prominent problem in energy-efficient buildings, constituting 23% of the total heat consumption. Another problem encountered was heat loss through pipes, which constituted approximately 5%–10% of the total heat consumption and was highly dependent on the actual conditions. In distribution networks, problems such as high resistance, high operational flow, and low pump efficiency were also identified and analyzed. Finally, practical energy-efficiency suggestions and future potential targets for the Chinese DHS are discussed from both a design and operational perspective.