Two lodges were established in Hong Kong soon after the British acquired the Territory. The older one, Royal Sussex Lodge No. 501 EC (named after the Duke of Sussex, who was then the Grand Master of the English Freemasons) was warranted on 18 September 1844. It later moved to Guangzhou, then on to Shanghai and only returned to Hong Kong in 1952. The second lodge, Zetland Lodge No. 526 EC was warranted on 21 March 1846. It was named after the Marquis of Zetland, the next Grand Master. Zetland Lodge claims seniority over Royal Sussex Lodge as it has remained in Hong Kong since its formation. Other Lodges were established over the following years.

In 1853 Zetland Lodge built a hall for its meetings on the upper part of Zetland Street where New World Tower now stands. This was the first Zetland Hall and in time it became the meeting place of all the Hong Kong lodges.

In China, lodges were formed in Shanghai, then in Ningbo and Tianjin. Lodges were formed eventually in most of the ports of China that were open to foreigners, and in the inland cities of Nanjing, Beijing, Harbin and Chengdu. These operated under charters granted by the supreme Masonic authorities in many countries, with those with most lodges being from England, Scotland, Massachusetts and later, the Philippines.

Because of restrictions imposed by the Imperial Government, it was almost impossible for a Chinese to become a freemason during the Qing Dynasty, although in 1873 the leader of a Chinese educational mission in Massachusetts did so. The first known Chinese to become a mason in China was Bro. Shan Hing Yung, a lieutenant in the Imperial Navy, who was initiated into Lodge Star of Southern China No. 2013 EC in Guangzhou in 1889. Early Chinese freemasons in Hong Kong included Sir Kai Ho Kai and the Honourable Wei Yuk.

By the beginning of the Sino-Japanese War, many lodges in China had a majority of Chinese members, especially those meeting under the Grand Lodge of the Philippines. During the war, the Japanese persecuted Freemasons in the occupied areas of China. Lodges however continued to meet. Several of the Hong Kong lodges met informally and under very dangerous conditions in the internment camps and Perseverance Lodge No. 1165 EC, meeting in Stanley prison, even kept a minute book.

With the end of the war, the lodges in China and Hong Kong revived, although some Lodges moved from the provinces into Shanghai, Tianjin and Hong Kong. Enthusiasm was so great that the six Philippine lodges meeting in China, which had an almost entirely Chinese membership, formed the Grand Lodge of China in 1949.

With the establishment of the People's Republic of China, all the lodges continued to meet, but those that met in the American Masonic Temple in Shanghai - including the Grand Lodge of China - closed down in 1952. The English District Grand Master of Northern China offered to close if the Central Peoples' Government requested it, affirming that regular Freemasons always give obedience to the lawful government of whichever country they are in. No request was made and the British lodges meeting in the Masonic Hall in Beijing Road West in Shanghai continued to meet without difficulty. Cosmopolitan Lodge No. 428 SC met there until 1962, when it transferred to Hong Kong. This was because its largely foreign membership had by then left China and not because of any conflict with the authorities. The British Masonic Hall then became the Shanghai headquarters of the Five Chinese Medical Associations.