Multilocus sequence typing (MLST) data have revealed many insights into the global epidemiology of Staphylococcus aureus but, with notable exceptions such as Japan, the evidence from most Asian countries is currently limited. Here we have applied MLST to 132 hospital-acquired meticillin-resistant Staphylococcus aureus (HA-MRSA) isolates collected in mainland China in 2002. In all, 102 isolates were recovered from a single tertiary hospital in Guangzhou, South China, and the remaining 30 isolates were recovered from six metropolitan tertiary hospitals from geographically diverse districts corresponding to a total area of more than 2 million km2. The data reveal a striking predominance throughout mainland China of a single clonal lineage, ST 239, which accounts for 97% of the 132 isolates. These data support more limited evidence from previous studies suggesting the widespread predominance of ST 239 throughout hospitals in China, a pattern which possibly extends to the whole of continental Asia. Staphylococcal chromosome cassette mec (SCCmec) typing confirmed the homogeneity of the ST 239 isolates, with the vast majority corresponding to the Hungarian clone (ST 239-III).