Background and Objectives: EUS has become a very frequently used procedure for both diagnostic and therapeutic indications. However, skilled operators are essential for improved outcomes and patient safety which make efficient training and certification programs essential. Our aim was to explore the acquisition and assessment of EUS competencies in China as practiced in the past, today, and in the future. Methods: We identified key opinion leaders (KOLs) from hospitals in different cities in China. Each KOL answered 43 questions regarding demographics and EUS experience, their learning experience as a trainee, experience as a supervisor, and their thoughts about current and future training. Descriptive statistics were used for reporting the results. Results: Eleven men and five females from eight major Chinese cities (Beijing, Changsha, Chengdu, Chongqing, Guangzhou, Shanghai, Shenzhen, and Wuhan) were included. They offered a good variance regarding age (33-53 years old), EUS experience (½-20 years), and performed procedures (20-6000 procedures). Most (n = 13) learned EUS through apprenticeship training model but three were self-taught. The KOLs also used the apprenticeship model to train their own trainees. First, they demonstrated EUS for median 2 months before their trainees took over the scope and performed a median 50 supervised procedures during a median of 3 months. Then they were allowed to perform EUS procedures independently. Simulation-based training and standardized assessment of competence were used very sparingly, but most of the KOLs wanted to shift towards these contemporary methods in the future. Conclusions: The classical apprenticeship training is still used to learn EUS in China and the amount of training required before being allowed to practice independently varies considerably. Several of the KOLs requested improved conditions for training and wanted a standardized curriculum leading to certification of new EUS operators based on a valid assessment of competence.