Economic cooperation is one of the priority areas in the "Belt and Road Initiative" proposed by China. It is important to examine the characteristics and patterns of development of trade between China and countries in the "Belt and Road Initiative" area, for achieving "unimpeded trade" and promoting economic prosperity and regional cooperation. Under this background, this article reviews the changing trend of commodity structure of trade between China and countries in the "Belt and Road Initiative" area, and analyzes the commodity structure and pattern, based on the revealed comparative advantage index (RCA), sensitive industry identification method, and k-medium value clustering. The results show that the commodity structure of China's export to these countries has improved, while import has been more centralized with increasing share of energy. Second, the main products that China exports to these countries are mechanical equipment and textiles and garments, while the main products that China imports are mostly energy, textiles and garments, and mechanical equipment. Third, sensitive industries involved in China's exports include clothing and shoes, nonmetallic minerals, transportation equipment and so on, and those involved in China's imports are mainly ores, energy, and some primary processed products. Fourth, at the provincial level, eastern, central, and some western provinces that do not share border with other countries, are mainly connected to Southeast Asia, West Asia, and Middle East, while western and northern border provinces are mainly dependent on trade with neighboring countries in the area, and have more ties with Central Asia, South Asia, and Mongolia-Russia. Most eastern provinces, central provinces, and several fast-growing western provinces are mainly exporting mechanical equipment, while most northwestern provinces are mainly exporting clothing. On the other hand, energy is the main product imported to Qinghai, Xinjiang, Liaoning, Heilongjiang, and other eastern provinces, while ores and metal products are main imported to most western provinces.