Background　Up to now, the methods of monitoring the depth of anesthesia have been mainly based on electroencephalogram(EEG) analysis, which mainly reflects the state of consciousness, and is not sensitive to autonomic nervous system activity in clinical anesthesia.　Objective　To review the value of heart rate variability(HRV) analysis for assessment of the autonomic nervous system in the depth of anesthesia monitoring.　Content　To summarize the progress of the depth of anesthesia monitoring methods in recent years，the limitation of the existing depth of anesthesia monitoring methods and application of evaluation of autonomic nervous activity in the depth of anesthesia monitoring.　Trend　Application of HRV analysis in evaluation of autonomic nervous system function will make the depth of anesthesia monitoring more perfect.