Abstract: Heat stroke is an imbalance of heat production and heat dissipation due to exposure to a thermal environment and/or intense exercise, characterized by increasing core temperature＞40℃ and central nervous system abnormalities such as altered mental state, convulsions or coma, accompanied by a life-threatening clinical syndrome of multiple organ damage. The common pathophysiological processes of heat stroke include oxidative stress, inflammatory reaction, coagulation dysfunction, rhabdomyolysis, intestinal micro-dysbiosis and so on. These pathological processes damage tissues and organs in a variety of ways, resulting in multiple organ dysfunction syndrome. This paper reviews the pathophysiological studies on the pathogenesis of heat stroke in recent years, in order to provide new ideas for its clinical treatment and further research.