Abstract: The Opinions of the CPC Central Committee and the State Council on Promoting High-Quality Urban Development explicitly propose support for “resident-led renewal and in-situ demolition-reconstruction of old residential buildings.” Against the backdrop of weakening land finance and the limited capacity of comprehensive renovation in old neighborhoods to meet residents’ needs, resident-led, in-situ demolition-reconstruction may become an important measure for transforming the urban development model, stimulating real domestic demand, and expanding effective investment. This paper compares the development trajectories and policy innovations of in-situ demolition-reconstruction in several Chinese cities and conducts in-depth investigation of eight typical cases. It finds that this renewal model is characterized by government leadership, state-owned-enterprise operation, mutual public-private benefits, limited physical improvement, and inclusive balancing, yet it is still insufficient to be defined as genuine resident-led renewal. The paper further identifies common bottlenecks at the levels of policy and law as well as value balancing, and proposes institutional designs in two respects: establishing a legal system that allows genuine resident-led renewal and releasing sustainable renewal momentum. The aim is to provide ideas for how old residential buildings can truly realize resident-led in-situ demolition-reconstruction.