Abstract: OBJECTIVE To summarize the strategies and potential drugs that can improve the oxygen affinity of red blood cells in the hypobaric and hypoxic environment in the current research. METHODS The retrieved literatures were screened, extracted and summarized by referring to the literature on the relationship between hypobaric hypoxic environment and erythrocyte oxygen affinity in CNKI database, Web of Science database and Pubmed database. RESULTS Under the hypobaric and hypoxic environment, the body’s oxygen uptake capacity and oxygen utilization efficiency decreased, resulting in the body being in a state of hypoxia. Improving the oxygen affinity of red blood cells could help the body adapt to and get used to the hypobaric and hypoxic environment, and many improvement methods had been applied in other diseases. CONCLUSION Improving the oxygen utilization rate of red blood cells by increasing the oxygen affinity of erythrocytes under hypobaric and hypoxia environment is the starting point and focus of the current research on preventing the damage of high altitude hypobaric and hypoxic environment to the human body.