Abstract: Keloid can be disfiguring functionally, aesthetically, or both, and its treatment remains a challenging clinical problem despite numerous proposed therapies reported.The exact pathogenesis of keloid is unknown.Currently, many studies have confirmed that mechanical signal transduction pathway plays an important role in scar formation.The TGF-β/Smad pathway is a research hotspot recently and its role in mechanoresponsiveness has been proven.This paper aims to summarize the latest research progress of TGF-β/Smad pathway and help clinical physicians understand the pathogenesis of keloid better.