Lung transplantation（LTx）is an effective treatment for end-stage lung disease，significantly prolonging patient survival and improving quality of life. However，bronchiolitis obliterans syndrome（BOS），which represents a frequent manifestation of chronic rejection following LTx，significantly compromises long - term patient survival. Consequently，early diagnosis and comprehensive treatment are crucial for improving prognosis，while exploration of individualized therapeutic strategies is needed to optimize clinical management. This review comprehensively examines the clinical manifestations，diagnostic approaches，pathogenesis，risk factors，therapeutic strategies，and prognostic characteristics of BOS，aiming to provide evidence-based guidance for clinical management and future research directions.