The State of Ohio and Hubei Province established sister province/state relations in 1979. Toledo City and Qinhuangdao City of Hebei (1985), Cincinnati and Liuzhou City of Guangxi (1988), Columbus and Hefei City of Anhui (1988), Toledo City and Nanchong City of Sichuan(2018) are sister cities.

In 2023, Ohio's total trade in goods with China was US$12.16 billion. Exports to China were US$2.77 billion. Imports from China were US$9.39 billion.