Objective: To understand the profile of genetic counseling (GC) and genetic testing (GT) in gynecologic oncology, identify deficiencies in GC competencies and barriers to incorporating GC into routine practice in China. Design: A cross-sectional study. Setting: A national sample of Chinese gynecologic oncology physicians. Population or Sample: Chinese gynecologic oncology physicians who were involved in managing patients with gynecologic oncology GC. Methods: Physicians were contacted via the membership of China Network of Ob and Gyn Institutions and Gynecologic Oncology Genetic Counseling Working Group, and required to fill in questionnaires via email and Wechat group notifications. Main Outcome Measures: Most respondents did not indicate a good knowledge of hereditary gynecological oncology, GC practice, as well as a good performance in clinical practice. Results: Regression analysis highlighted significant predictors of greater clinical practice of gynecologic oncology GC among physicians with medical degrees, a better understanding of gynecologic oncology and a better understanding of GC. Furthermore, nearly all gynecological oncologists exhibited a positive attitude towards GC, and generally agreed that the domestic GC education and training system needed to be strengthened. Conclusions: We believe the findings can offer key lessons for the development of medical genetics in China and also further LMICs where medical genetics is poorly incorporated into daily practice. Actions to ensure quality of care, equity, and universal coverage of GC for people in need should be taken.