In social and political sense, Macau can be referred to as “an associational society”. Since its handover to China, Macau has witnessed a rapid growth in the quantity and density of well-structured and multi-function associations. Unlike general non-profit organizations, associations in Macau are indispensable components of the society. However, the development of associations in Macau is facing increasing challenges due to drastic changes in Macau’s political, economic and social environment. In order to develop in a sustainable way in the future, Macau associations need to reform in the following aspects: repositioning and improving service to a professional standard, reinforcing their internal democratic management and institution building, attracting and cultivating more talents, strengthening self-discipline, and enhancing transparency and credibility.