Polycyclic aromatic hydrocarbons (PAHs) in river sediments in China have been extensively investigated. However, most previous studies only reported information about specific locations. As a result, the distribution and changes of these chemicals in sediments nationwide remain unknown. Based on published data during 1997–2020, we conducted a systematic meta-analysis to understand the concentration, risk and the spatiotemporal variation of PAHs in river sediments from the seven major river systems in China. The report provides a national picture of PAHs in river sediments of China. Among the seven river systems, higher concentrations of sediment PAHs are found in the basins of Liaohe River and Haihe River. In the study sediments, high-molecular-mass (4–6-ring) PAHs were predominated, reflecting the widespread combustion of coal and fossil fuels across China. In addition, PAH source assessment also suggests that raw coal and crude oil are important contributors to PAH concentrations in the rivers in northeastern China. Over the past 20 years, there is no downward trend in the concentrations of Σ₁₆PAHs in sediments in the seven river basins; but the contribution of high-temperature combustion to the pollution has declined. In addition, our calculated risks from sediment PAHs seem to decline between 1997–2006 and 2007–2017 periods, although the differences were not statistically significant (p > 0.05). Of note, the data collection and the risk assessment methods used in this preliminary survey may result in some uncertainty. Our results suggest that the PAHs in river sediments in China still need to be paid attention to due to the complexity of their sources and harms to aquatic organisms.