Background　Interscalene brachial plexus block（ISBPB） is regarded as an effective method of anesthesia and analgesia for shoulder and upper extremity surgery. Anesthesiologists always focus on its immediate complications such as local anesthetics poisoning， but they pay less attention for its delay or long-term complications， such as phrenic nerve paralysis after ISBPB.　Objective　Reviewing domestic and foreign research on diaphragm paralysis incidence after ISBPB and providing the optimal reference dosage of local anesthetics for ISBPB.　Content　Elaborating cause， harmfulness， influence factors， diagnosis， prevention and treatment of diaphragm paralysis after ISBPB.　Trend　Under the accurate positioning of ultrasound combined with nerve stimulator， applying 0.375% ropivacaine 5 ml to 10 ml in ISBPB as soon as possible can result in a satisfactory anesthesia and postoperative analgesia effect and lower incidence of diaphragm paralysis.