Abstract: In recent years, multiple drug-resistant bacteria, extensively drug-resistant bacteria, and even pan drug-resistant infections have appeared continuously, which has brought serious challenges to the diagnosis and treatment of clinical infections. Fosfomycin has a unique antibacterial mechanism, it is highly effective in the treatment of multidrug-resistant microorganisms. This review focuses on the latest progress in the antibacterial mechanism, antimicrobial activity, resistance mechanism, clinical application of fosfomycin.