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Objective: To preliminarily evaluate the efficacy and safety of sotatercept in patients with pulmonary arterial hypertension (PAH) in China. Methods: This single-center, retrospective case series analysis included seven consecutive PAH patients treated at Ruijin Hainan Hospital, Shanghai Jiao Tong University School of Medicine, who received sotatercept in addition to stable background therapy from May to December 2025. Key efficacy indicators included 6-minute walk distance (6MWD), World Health Organization functional class (WHO FC), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and systolic pulmonary artery pressure (PASP). The core safety indicators were the dynamic changes in hemoglobin (Hgb) and platelet count (PLT). Results: Of the seven patients treated with sotatercept, one received only a single dose and discontinued for personal reasons, and was therefore excluded from subsequent analysis. The remaining six patients completed one-month follow-up, with three completing both one-and three-month follow-ups. At one month, 6MWD significantly improved in five of six patients (5/6), with further improvement in two of three patients (2/3) at three months. At the one-month follow-up, NT-proBNP significantly decreased in five of six patients (5/6) compared to baseline, with further reduction in one of three patients (1/3) at the three-month follow-up. At the three-month follow-up, echocardiographic estimates of pulmonary artery pressure decreased in two of three patients (2/3), and WHO FC improved in two of three patients (2/3). Among the six patients, one (1/6) had a delayed sotatercept dose due to an excessive increase in hemoglobin, and one developed a decrease in platelet count; no other adverse reactions occurred. Conclusions: Sotatercept demonstrated significant short-term improvements in cardiac function and exercise capacity in Chinese PAH patients, with a manageable safety profile. However, due to the small sample size and short follow-up period, these findings require further validation through large-scale, long-term prospective studies.