Significant changes occurred in the topography of China during the Cenozoic from west-tilting earlier to east-tilting at the present. It was suggested that the reversal of the topographic trend forced the reconstruction of the Asian and even the global climate and environment. Based on the slip-line field theory and the hypothesis of eastward extrusion tectonics of Asia, this study discussed a semi-quantitative test of the paleotopographic evolution of China during the Cenozoic. The results showed that rapid uplift occurred in the west, progressive subsidence in the east and minor elevation change in the middle during the paleotopographic evolution. The initial reversal of the relief trend was formed at about 10 Ma after the initial continental collision and the elevation difference has been increasing since then. The present topography of China was formed in the recent 10 Ma.