The parapharyngeal space is an important soft tissue space in the head and neck, through which has many important blood vessels and nerves pass.Its location is deep and its structure is complex, and the surgical exposure is difficult. Although the incidence of parapharyngeal space tumors is not high, mainly benign tumors, their pathological types are diverse.The location and pattern of parapharyngeal space tumor growth are very different.In order to achieve good exposure in parapharyngeal space tumor surgery, a variety of surgical approaches have been clinically developed. In recent years, advances in endoscopic techniques have promoted the development of parapharyngeal space tumor surgery. In order to understand the progress of clinical surgery for parapharyngeal space tumors, this article summarized the current surgical approaches and development of parapharyngeal space tumors.After summing up many kinds of clinical pathways, some suggestions on the surgical approaches for some common parapharyngeal space tumors were put forward. At the same time, some suggestions on the regional division of the parapharyngeal space and the regional treatment of the parapharyngeal space tumors were put forward.