Recurrent spontaneous abortion（RSA）is a disease which seriously threaten the physical and mental health of pa⁃ tients，and it is also an important factor leading to the impairment of fertility in women of childbearing age.The etiology of RSA includ⁃ ing chromosomal abnormalities，autoimmune abnormalities，maternal-fetal immune disorders，thrombophilia，endocrine dysfunction and abnormal anatomy of reproductive system，and about 25% of patients have no clear etiology.Therefore，the diagnosis and treatment of RSA are of difficulties，and inadequate or excessive diagnosis and treatment are common.Autoimmune abnormalities are one of the most important causes of RSA，accounting for about 30% of all causes of RSA.However，there are some uncertainties in diagnostic criteria，examination and treatment of autoimmune RSA.This article provided an analysis and commentary on the current controversies and hot topics in the clinical diagnosis and treatment of autoimmune RSA，as well as existing research results.It also provided an outlook on fu⁃ ture development directions and proposed a classification and screening strategy for autoimmune RSA.