Hydropower dams are back in the spotlight owing to a shifting preference for low carbon energy generation and their possible contribution to mitigating climate change. At the forefront of the renaissance of large hydropower dams are Chinese companies, as the builders of the world’s largest dams at home and abroad, opening up opportunities for low- and middle-income countries. However, large hydropower dams, despite their possible developmental and carbon reduction contributions, are accompanied by huge economic costs, profound negative environmental changes and social impacts. Using fieldwork data from four hydropower projects in Ghana, Nigeria, Cambodia and Malaysia, this paper evaluates the behaviour of Chinese stakeholders engaged in large hydropower projects in Asia and Africa. We do this by first exploring the interests of the different Chinese stakeholders and then by investigating the wider implications of these Chinese dams on the local, national and international contexts. The paper concludes that hydropower dams will continue to play a prominent role in future efforts to increase energy security and reduce energy poverty worldwide, therefore the planning, building and mitigation strategies need to be implemented in a more sustainable way that takes into account national development priorities, the needs of local people and the impacts on natural habitats.