Pyroptosis is a form of lytic, programmed cell death triggered by inflammatory caspases, primarily caspase-1 and caspase-11, and plays a critical role in defending against intracellular pathogens. It removes the pathogen's replication niche, making it susceptible to phagocytosis. However, excessive pyroptosis can lead to sepsis. The review discusses the molecular and morphological characteristics of pyroptosis, the role of inflammasomes in detecting pathogens, and how pathogens evade pyroptosis. Key inflammasomes include the NLRC4, AIM2, IFI16, NLRP3, and NLRP1 inflammasomes, each with distinct mechanisms of activation and roles in immune defense. Pathogens such as Salmonella, Listeria, Francisella, and Shigella have evolved strategies to avoid pyroptosis, including suppressing flagellin expression, modifying ligand structure, or directly inhibiting inflammasome function. Viruses also employ strategies to inhibit inflammasome activation, such as encoding proteins that mimic ASC or inhibit caspase-1. The review emphasizes the balance between protective and harmful roles of pyroptosis and the need for further research to understand its role in disease and develop therapeutic strategies for sepsis.Pyroptosis is a form of lytic, programmed cell death triggered by inflammatory caspases, primarily caspase-1 and caspase-11, and plays a critical role in defending against intracellular pathogens. It removes the pathogen's replication niche, making it susceptible to phagocytosis. However, excessive pyroptosis can lead to sepsis. The review discusses the molecular and morphological characteristics of pyroptosis, the role of inflammasomes in detecting pathogens, and how pathogens evade pyroptosis. Key inflammasomes include the NLRC4, AIM2, IFI16, NLRP3, and NLRP1 inflammasomes, each with distinct mechanisms of activation and roles in immune defense. Pathogens such as Salmonella, Listeria, Francisella, and Shigella have evolved strategies to avoid pyroptosis, including suppressing flagellin expression, modifying ligand structure, or directly inhibiting inflammasome function. Viruses also employ strategies to inhibit inflammasome activation, such as encoding proteins that mimic ASC or inhibit caspase-1. The review emphasizes the balance between protective and harmful roles of pyroptosis and the need for further research to understand its role in disease and develop therapeutic strategies for sepsis.