Abstract: Prenatal stress (PS), as an important form of intrauterine adversity, has drawn growing attention for its long-term impacts on offspring health. In recent years, extensive studies have revealed that PS disrupts offspring development, particularly showing a close association with increased risks of diseases such as asthma. However, the precise underlying mechanisms remain poorly understood. Therefore, this paper focuses on the effects of prenatal stress on the structure and function of the respiratory system in offspring, systematically reviewing potential mechanisms including hypothalamic-pituitary-adrenal (HPA) axis activation, immune dysregulation, abnormal Wnt signaling pathway, and epigenetic modifications, while exploring their interactions, with the aim of providing a theoretical basis for early intervention.