The year 2020 marked two decades since the start of the Forum on China–Africa Cooperation (FOCAC). The past 20 years have seen China reshaping Africa’s development landscape while raising questions about the nature of African agency in relation to Chinese power. 2021’s FOCAC summit is the first to be held in West Africa. Regional powers have made massive strides in harnessing China’s power to boost their own development plans. However, much work remains to ensure that African agendas get the attention they need. This work takes on even more urgency in the wake of significant shifts in Chinese lending. This paper uses the newest summit as an occasion to take the temperature of the Africa– China relationship, with a specific focus on West Africa. It draws on interviews with a broad range of West African diplomats, policymakers and businesspeople to map the region’s priorities in its Chinese interactions. These include health, debt and cooperation on regional integration and economic recovery. It also makes suggestions on how the region can leverage its relationship with China to further its development goals.