The middle and lower Yangtze River floodplain is a globally important wintering area for waterbirds in the East Asian-Australasian Flyway. Ornithologists have reported on wintering waterbirds in the floodplain since the 1950s. However, an integrated analysis of the long-term changes in waterbird diversity is not available. Here, we synthesise existing information on changes in wintering waterbird abundance and distribution in the floodplain, summarise possible influencing factors and propose some priorities for further research. Waterbird richness and abundance have declined over the past 60 years. Declining trends have been observed in a number of areas and species. Nevertheless, a few areas and species showed different trends. In addition, waterbirds have become more concentrated in a few suitable areas such as Poyang Lake and Dongting Lake. Land reclamation, hunting, dam operation and extensive aquaculture are probably the four major threats to wintering waterbirds, while establishment of nature reserves is beneficial to waterbird conservation. Our study suggests that waterbirds in the floodplain are vulnerable, and that effective conservation measures are needed to protect and restore the waterbird diversity of this area.