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Objectives To assess the trends of autism spectrum disorders (ASD) in China and globally, to extract the epidemiological characteristics and to predict the burden in 2030. Data on the prevalence and disability-adjusted life years (DALYs) for ASD from 1990 to 2021 were collected from the Global Burden of Disease (GBD) database.Methods The Join-point regression model was used to analyse changes in the disease burden of ASD over time, and the Auto-regressive Integrated Moving Average (ARIMA) model was employed to predict the trend by 2030.Results From 1990 to 2021, the age-standardised prevalence and age-standardised DALYs rate of ASD in China were lower than the global average level. However, the average annual percentage change (AAPC) in these rates was 0.22% for prevalence and 0.23% for DALYs, which were higher than the global average levels. It is forecasted that the disease burden of ASD in China showed an uptrend by 2030, corresponding to the age-standardised prevalence of 660.28 per 100 000 and age-standardised DALYs rate of 126.66 per 100 000. In comparison, the global levels are 793.01 per 100 000 and 147.43 per 100 000 by 2030, respectively.Conclusions Our findings demonstrate a strong positive correlation between the age-standardised prevalence and DALYs rate of ASD and sociodemographic index (SDI) across most countries. The health impact of ASD has been on an upward trajectory over the past three decades. ASD significantly contributes to health loss, particularly among preschool boys. The disease burden of ASD in China is likely to increase progressively in the future, highlighting the urgency of implementing targeted prevention and control measures.