Background　Fentanyl is widely used in acute postsurgical and chronic pain. Interindividual variability in response to fentanyl is a significant challenge in the management of pain. Considerable evidence concerning a sound genetic background of this human intervariability has prompted research on the field of a personalized therapy. And genetic polymorphisms of catecholamine-O-methytransferase（COMT）， opioid receptor μ 1（OPRM1）， cytochrome（CY） P450，CYP3A4/5 and P-glycoprotein （P-gp） are studied mostly.　Objective　To summarize pharmacogenetic data associated with fentanyl frequently encountered in managed care settings.　Content　This review focuses on findings related to pharmacogenetics of fentanyl， and highlights authors′ views on future clinical implications of pharmacogenetics.　Trend　Personalized therapy of fentanyl still has a long way to go. Future studies may be focused on interaction of environmental and genetic factors， epigenetics and the regulation of microRNA.