The article reviews the causes, mechanisms, and treatments of thin endometrium (TE), which is defined as an endometrial thickness ≤7mm. TE can lead to reduced embryo implantation rates and adverse pregnancy outcomes, making it a significant challenge in assisted reproductive technology (ART). The causes of TE include hormonal influences, uterine cavity factors, and long-term oral contraceptive use. Treatment options include pharmacological interventions (hormonal and vasoactive drugs), regenerative medicine, intrauterine infusion of growth factors, autologous platelet-rich plasma, and complementary therapies such as traditional Chinese herbal medicine and acupuncture. However, the mechanisms of action for many of these treatments are not fully understood. The article highlights the need for more clinical studies to improve treatment outcomes and increase pregnancy rates in patients with TE.The article reviews the causes, mechanisms, and treatments of thin endometrium (TE), which is defined as an endometrial thickness ≤7mm. TE can lead to reduced embryo implantation rates and adverse pregnancy outcomes, making it a significant challenge in assisted reproductive technology (ART). The causes of TE include hormonal influences, uterine cavity factors, and long-term oral contraceptive use. Treatment options include pharmacological interventions (hormonal and vasoactive drugs), regenerative medicine, intrauterine infusion of growth factors, autologous platelet-rich plasma, and complementary therapies such as traditional Chinese herbal medicine and acupuncture. However, the mechanisms of action for many of these treatments are not fully understood. The article highlights the need for more clinical studies to improve treatment outcomes and increase pregnancy rates in patients with TE.