The State of Massachusetts and Guangdong Province established sister province/state relations in 1983. Boston and Hangzhou city of Zhejiang (1982), Brockton and Zaozhuang city of Shandong (2000), Atepolo and Yangzhou Baoying County of Jiangsu (2007), Cambridge and Beijing Haidian District (2016) are sister cities. Shelburne Falls and Mutianyu, Huairou District of Beijing are friendship villages. Since 2022, May 1 has been officially designated by Boston as "Boston-Hangzhou Day".

In 2023, Massachusetts' total trade in goods with China was US$6.64 billion. Imports from China were US$3.34 billion; exports to China were US$3.3 billion.