Abstract: Nucleus accumben is located in the ventral striatum and is mainly composed of medium-sized polyspinous γ-aminobutyric acid (GABA) neurons. According to their different expression receptors, the neurons can be subdivided into neuronal subtypes expressing dopamine D1 receptor, dopamine D2 receptor, adenosine A1 and A2A receptor. Previous studies have found that the nucleus accumben is involved in the regulation of reward, addiction, feeding, learning, sleep-wake and other neurobiological behaviors, and has complex fibrous connections with the cortex and midbrain dopaminergic nuclei. Recent studies have shown that the nucleus accumben also plays an important role in the consciousness regulation of general anesthesia, which opens up new horizon for the mechanism of general anesthesia. Therefore, this review focuses on the role of each subtype of neurons in the nucleus accumbens and their projection pathways in sleep-wake and general anesthesia.