On November 3, 2023, President Xi Jinping sent a letter to the Fifth China-U.S. Sister Cities Conference.

Xi Jinping pointed out that the foundation of China-U.S. relations lies in the people and the source of strength lies in the friendship between the people. Sister provinces/states and sister cities are important players in deepening friendship between Chinese and American peoples and achieving mutual benefits and win-win results. Since the first pair of cities were twinned in 1979, 284 pairs of sister provinces/states and sister cities have been formed between China and the U.S. Over the past four decades and more, they have engaged in close cooperation, delivering fruitful results and bringing tangible benefits to the two peoples.

Xi Jinping stressed that the China-U.S. Sister Cities Conference is an important mechanism for sub-national exchanges between China and the U.S. Since its inception, it has played a positive role in promoting the development of  sister cities and deepening their cooperation. Xi Jinping expressed the hope that the participants of the conference will continue to serve as a bridge for sub-national exchanges between China and the U.S. and help the provinces/states and cities of the two countries to cross the vast Pacific Ocean to play a greater role in promoting the sound and steady development of China-U.S. relations and improving the well-being of the two peoples.

The Fifth China-U.S. Sister Cities Conference was held on that day in Suzhou City, Jiangsu Province. Themed "Build Green Cities for the People", the conference is co-hosted by the Chinese People's Association for Friendship with Foreign Countries and the Jiangsu Provincial People's Government.