Abstract: Thrombotic microangiopathy （TMA） is a group of clinical syndromes characterized by microvascular hemolytic anemia （MAHA）， thrombocytopenia and ischemic organ damage. TMA mainly affects the kidneys， and also involves other systems， such as the central nervous system， cardiovascular system， respiratory system and digestive system. The etiology of TMA is complicated and diverse， and can be mediated by activity deficiency or complement dysregulation of ADAMTS13 （a metalloproteinase with thromboreactive protein type 1， member 13）. TMA can also be secondary to infection， pregnancy， drugs， autoimmune diseases， hematopoietic stem cell transplantation， etc. The classification and naming of TMA based on distinct pathogenic mechanisms contributed to the timely and accurate diagnosis and treatment of TMA， thus improving the survival. This article provided an overview of the clinical presentations， etiology， diagnostic modalities， and therapeutic options for various subtypes of TMA.