Ventilator-induced diaphragm dysfunction(VIDD) is highly prevalent in patients receiving mechanical ventilation, even in the early stage of treatment, and has become one of the most crucial factors which leads patient failure to wean from the ventilator. VIDD also increases the morbidity of pulmonary infections and other systemic complications. VIDD is mainly manifested by diaphragmatic muscle fiber atrophy and decreased contractility, which can be caused by reduced discharge of the phrenic nerve, increased intracellular calcium ion concentration, or cytokine imbalance. Pathogenesis of VIDD involves multiple signaling pathways to active the complex protein hydrolysis regulatory nets, and then accelerate muscle fiber catabolism and caused cell autophagy or apoptosis. Diaphragm excursion and diaphragm thickening can be assessed by using bedside ultrasonography, which may assist physicians to identify VIDD. Clinical strategies such as optimizing ventilator modes and parameters, administering combined pharmacological agents, inspiratory muscle training, phrenic nerve pacing or stimulating and nerve grafts may be applied to prevent or alleviate the progress of VIDD.