The analgesic effect of nicotine has been tested in animals and human for a long time, although its analgesic mechanism is very complex. So far, there are 9 related clinical trials, in which the conclusions are different. Therefore, it has not been widely used in clinical practice. Firstly, the physiological mechanism of its analgesic was concluded into 3 aspects from supraspinal, spinal and peripheral. And then, made a summary of 9 clinical trials to analyze the different conclusions. Those factors involved in nicotine analgesia included the history of smoking, the objective in pain scores, the methods of anesthesia, gender, the type and time of the operation and the nutritional status. This article reviewed the analgesic effect of nicotine from its physiological mechanism to clinical application， further ideas of research on the relationship between nicotine and pain were provided.