Due to the particularity of pathophysiology, obese patients often have respiratory problems such as difficult airways, hypoxemia, respiratory failure, and so on. Providing safe and effective respiratory support for obese patients has brought challenges to clinical anesthesia. As a new noninvasive auxiliary ventilation technology, the high flow nasal oxygen therapy (HFNO) has attracted extensive attention in clinical applications. This review introduces HFNO technology with its physiological effects and summarizes the application research of HFNO technology used during the perioperative period of obese patients in recent years. Meanwhile, the paper discusses the advantages and disadvantages of HFNO technology and provides a new technology for perioperative respiratory support for obese patients.