Against the backdrop of the rapid development of multicenter and interdisciplinary collaboration in medical research, establishing a standardized and efficient ethical collaborative review and mutual recognition system constitutes not only an urgent priority for advancing multi-institutional joint research but also a crucial measure in response to national policy orientations. Based on Jiangsu Province’s innovative practices in the field of ethical collaborative review, and through an analysis of common challenges in this field globally, this paper systematically put forward implementation strategies to ensure review quality and efficiency. These strategies encompassed establishing a regional ethics alliance to achieve resource integration and constructing supporting legal frameworks to strengthen institutional guarantees. Meanwhile, it was also crucial to enhance team professionalism, optimize multi-party collaboration models, and establish sustainable communication mechanisms, ultimately forming a scalable collaborative development framework for ethical review. The research outcomes can provide decision-making references and operational paradigms for the optimization and upgrading of the cross-institutional medical research ethics management system in China.