Abstract: Based on the analysis of progress and problems since the establishment of the current anti-doping system in the USA, the main difficulties of its anti-doping are revealed, including the lack of unified anti-doping legislation and control system, professional sports and school sports doping control needs to be strengthened, doping abuse in grassroots sports, numerous doping violations and malignant incidents. The anti-doping dilemma in the United States is mainly caused by the nature of professional sports and NCAA, as well as the reality of legislation and judicatory under the background of national interest first, America First principle and liberalism, which will be difficult to change fundamentally in the short term. Taking the United States as a mirror, while taking international and national athletes as the main targets for anti-doping control, in the unity of the Chinese anti-doping legislation and control system, China must distinguish the different athletes identity, distribute anti-doping responsibilities and cooperate among different departments, protect athletes rights, and build a "China model" of anti-doping.