The International Mathematical Olympiad (IMO) is one of the most important and influential global youth intellectual competitions. However, there is little research on how to effectively organize the competition at the national level to help cultivate talent in mathematics, science, and technology. The Mathematical Olympiad originated from a competition to solve mathematical problems. Many outstanding mathematicians and scientists have been prior winners of the IMO and have reaped benefits subsequently to some extent. The Mathematical Olympiad helps to select and train gifted students in mathematics. China’s outstanding historical achievements in the IMO have attracted the attention of the world. Many of China’s students, who exhibited exceptional performance at the IMO, later became outstanding mathematicians, scientists, and technologists. These achievements need to be publicized, and the Chinese experience at the Mathematical Olympiad needs to be summarized and promoted. This article summarizes the history of the IMO and reviews the practices of the IMO in China based on the literature. China uses a number of strategies to ensure outstanding results in the IMO, including: the selection of contestants from existing domestic programs (National High School Mathematics Joint Competition, Chinese Mathematical Olympiad, and National Training Team); a multi-level educational system based on school training; and the accumulation and publication of relevant learning materials. The outbreak of the novel coronavirus has affected the normal proceedings of the IMO, but China has implemented effective countermeasures. There are still some misunderstandings about the Mathematical Olympiad in China. By introducing prior contestants, who have participated in the IMO and made outstanding contributions, China can help the public better appreciate the Mathematical Olympiad. At the same time, the Chinese experience at the IMO is an important reference for other countries in organizing competition training and selecting and nurturing gifted students in mathematics.