As the demand for nuclear medicine diagnosis and treatment increases due to the population aging, a stable and reliable supply of medical isotopes, which serve as the material foundation for nuclear medicine, is a crucial prerequisite for promoting the development of nuclear medicine and safeguarding human health. This paper summarizes the current states of reactor−produced medical isotope production and supply, noting that China remains highly dependent on imports for the medical isotopes commonly used in clinical diagnostics and therapy. To address this, China has launched new projects to construct medical isotope production reactors. It is projected that China’s supply of key medical isotopes will continue to rely primarily on imports until 2027; after 2027, the self−sufficiency capacity for certain isotopes will significantly improve, and in the long term, it is expected to achieve complete self−sufficiency and even partial exports. However, the realization of the expected production capacity following the commissioning of these facilities still face multiple risks and challenges, such as the immaturity of production reactor operation management and supporting infrastructure, unclear pricing mechanisms for reactor−produced medical isotopes, and the incomplete spatial layout and commercial structure of research reactors and processing plants, which may lead to supply fluctuations or even shortages. It is proposed to strengthen the top−level design of medical isotope supply security, coordinate the planning, layout, and construction progress of production facilities; improve the operational management and supporting infrastructure of medical isotope production reactors, establish a pricing model and commercial structure for medical isotopes that aligns with national conditions, to promote the sustainable development of the supply chain.