Abstract： Objective::An increasing level of antimicrobial resistance to extended-spectrum cephalosporins has been reported, so we conducted this study to investigate the molecular characteristics of cephalosporin resistant Neisseria gonorrhoeae ( NG) strains isolated from China Gonococcal Antimicrobial Resistance Surveillance Programme (China-GRSP). Methods::In total, 2,038 NG isolates were collected from the China-GRSP between 2015 and 2016. NG multiantigen sequence typing ( NG-MAST), multilocus sequence typing (MLST), and NG sequence typing for antimicrobial resistance ( NG-STAR) were used to determine characteristics and resistant determinants of cephalosporin-resistant isolates. The results are described as percentages. Results::Seventy-four (3.6%) cephalosporin-resistant isolates were confirmed. MLST ST7363 was the most prevalent MLST among cefixime-resistant (CFX-R) isolates, whereas MLST ST7365 ( n = 8) in was the most prevalent sequence type among ceftriaxone-resistant (CRO-R) isolates. CFX-R strains were mainly associated with penA-X ( n = 27, 44.3%), penA-XIII ( n = 6, 9.8%), penA-XVIII ( n = 5, 8.2%), and CRO-R strains were mainly related to penA-XVIII ( n = 10, 25.6%), penA-43 ( n = 9, 23.1%), penA-XIII ( n = 7, 17.9%). Conclusion::The main conclusion of this study is that the predominant cephalosporin-resistant clones in China include locally emerged and imported linages. The CFX-R and CRO-R strains are primarily related to penA mutations, and their predominant genotypes are different. With the increase in international travel, tracking high-risk-resistant clones and identifying outbreaks and their associations with epidemiological characteristics are critical to improve public health.