Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak. The morbidity and mortality of FCDC has a significant upward trend in the global in recent years. All broad spectrum antimicrobials usage is considered to be the primary risk factor for the onset of FCDC. Therefore, FCDC has become a new challenge for clinical work. The epidemiology, related risk factors, pathogenesis, diagnosis, severity classification, recent progress in clinical treatment of FCDC were reviewed in order to provide help for clinical treatment of FCDC and related research.