Abstract: Lymphatic leakage is one of the postoperative complications in gynecologic malignancies, which we need to pay more attention to, especially for patients with higher-risk factors, such as obesity, anemia, excessive intraoperative blood loss and lymphadenectasis. Conservative methods are preferred after lymphatic leakage, including fasting, nutritional support, drug therapy, etc. For patients irresponsive to conservative methods, surgical treatment may be considered; ultrasound-guided intracranial lymphangiography is also a good alternative.In this article, we will review the anatomy and physiology of the lymphatic system, discuss the causes and high-risk factors of lymphatic leakage after gynecological pelvic surgery, and systematically elaborate the treatment methods and preventive measures based on our clinical experience.