Abstract Adolescent idiopathic scoliosis (AIS) is associated with multiple physical and mental health problems among adolescent patients. This is a multi-factor, multi-system process of disease evolution. Patients with mild scoliosis can choose to receive conservative treatment with braces and regular follow-up. Once scoliosis progresses, surgical correction is often required. With the development of surgical pedicle screw technology, surgical correction has achieved good results, but other negative effects of long-term follow-up of scoliosis are not clear. This paper summarizes the existing AIS pathogenesis from the aspects of heredity, hormone, nervous system, skeletal system and biomechanics.