Tourism is a strategic pillar industry for national economic development, which plays an important role in regional development. As an emerging field, tourism eco-efficiency has been an important tool to determine the sustainability of the tourism industry. On the basis of a literature review, large-scale studies measuring tourism eco-efficiency and exploring the results are limited. Limited research has focused on the regional differences of energy consumption when calculating tourism eco-efficiency. In this paper, the total tourism carbon emissions, including transportation, accommodation, and recreational activities in China from 2000 to 2013 were determined using the bottom-up method. In the calculation process, the differences of regional energy consumption structures were considered and eco-efficiency was determined. The tourism eco-efficiency of China and its regions were analyzed using the single ratio method with the calculated carbon emissions data. A coefficient of variation and Moran's index were used to analyze the total Chinese and provincial eco-efficiency, which could also be compared with the eco-efficiency of global sustainable development. The results showed that:(1) Chinese tourism carbon emissions have increased substantially and its total emissions reached 41.51 million tons in 2013 from 12.02 million tons in 2000. Besides, tourism carbon emission is very different among tourism sectors; the largest source is transportation, which accounts for about 90% of the total; (2) benefiting from policies on the promotion of tourism development from central and local governments, tourism eco-efficiency in China and its regions have improved; the value decreased from 0.1193 kgCO₂-e/$ in 2000 to 0.0309 kgCO₂-e/$ in 2013; (3) over time, based on the coefficient of variation, there was an imbalance in Chinese tourism eco-efficiency, where has increased from 0.7114 in 2000 to 0.7483 in 2013. Regarding spatial variation, there was a remarkable change in cluster patterns of tourism eco-efficiency, where Moran's index decreased from 0.3036 to 0.0287, which implied the spatial relations of eco-efficiency became weakened; (4) the sustainable development of the Chinese tourism industry has occurred since 2000, and was found to be superior to that of other industries. Moreover since 2010, the tourism industry in all regions of China has been in the sustainable development stage. Finally, the results suggested tourism eco-efficiency could be optimized by not only increasing tourism income, but also reducing tourism carbon emissions.