The sanxian is used in nanguan and Jiangnan sizhu ensembles, as well as many other folk and classical ensembles—such as Suzhou pingtan, and Beijing and Kunqu operas.

[6] Iterations of the sanxian are found among China's ethnic minorities as well, such as the Manchu, the Mongols, the Bai, the Yi, the Lahu, the Miao, the Dai, and the Jingpo.

[6] The instrument's rounded rectangular resonator has a snakeskin front and back, and the curved-back pegbox at the end of the neck has lateral, or side, tuning pegs that adjust three silk, nylon or steel strings.

Additionally, the sanshin and sanxian share a structurally similar body part consisting of a round-edged square of wood.

[citation needed] In addition to its use in traditional and classical Chinese music, some popular and rock musicians have used the sanxian, most notably the singer He Yong (何勇) and his father He Yusheng (何玉声).