The Central Economic Work Conference emphasized strengthening countercyclical adjustment, and the national macro balance sheet is a key basis for policy formulation. By reviewing the successful experiences and lessons learned from national macro balance sheet management in the United States, Japan, and the United Kingdom under countercyclical regulation, and combining these with China’ s actual economic conditions, this paper analyzes the current status and challenges of macro balance sheet management in China. The study finds that China’s macro balance sheet management faces challenges in countercyclical practice, including asset-liability structural imbalances, inefficient policy transmission mechanisms, and insufficient data quality and timeliness. To address these issues, this paper proposes innovative approaches in three aspects: optimizing the asset-liability structure, unblocking policy transmission channels, and enhancing the statement compilation and data management system, aiming to improve the management level of China’s national macro balance sheet and provide theoretical support and practical guidance for implementing more precise and effective countercyclical regulation policies.