In recent years, public health officials and scholars have voiced their concerns about comparatively low condom use in China, citing high rates of abortion and the growing HIV/AIDS crisis. By examining condom use through the lenses of gender and the history of medicine, this article traces heterosexual condom consumption in China from the early twentieth century to the present and situates contemporary attitudes toward condoms within long-term contraceptive patterns. Rather than simply taking for granted the role that men play in family planning decisions, this research takes men and masculinity as a central focus. An eye to the past reveals numerous historical obstacles to condom use, as well as an enduring aversion to condoms grounded in fears of reduced male sexual pleasure, and the gendered assumption that birth control is the sole responsibility of women. Analyzing evolving perceptions of condoms sheds light on constructions of sexuality, gender relations, and the roles of the state, society, and the individual in contraceptive decision-making in China.