The article reviews the current research progress in brain-targeted nasal drug delivery, highlighting the challenges and advancements in overcoming the blood-brain barrier (BBB) to enhance drug efficacy in treating central nervous system (CNS) diseases. The nasal cavity, with its direct anatomical pathway to the brain, offers a promising route for drug delivery, bypassing the BBB. The review covers the physiological structure of the nasal cavity and the brain, the pathways through which drugs can enter the brain via the nose, and factors affecting brain-targeted nasal drug delivery. It also discusses methods to improve brain-targeted nasal drug delivery, including the use of penetration enhancers, mucosal adhesives, and new drug delivery systems such as liposomes, in situ gels, microspheres, emulsions, and nanoparticles. The article concludes by emphasizing the broad application prospects of brain-targeted nasal drug delivery in treating CNS diseases, while acknowledging the limitations and future research directions.The article reviews the current research progress in brain-targeted nasal drug delivery, highlighting the challenges and advancements in overcoming the blood-brain barrier (BBB) to enhance drug efficacy in treating central nervous system (CNS) diseases. The nasal cavity, with its direct anatomical pathway to the brain, offers a promising route for drug delivery, bypassing the BBB. The review covers the physiological structure of the nasal cavity and the brain, the pathways through which drugs can enter the brain via the nose, and factors affecting brain-targeted nasal drug delivery. It also discusses methods to improve brain-targeted nasal drug delivery, including the use of penetration enhancers, mucosal adhesives, and new drug delivery systems such as liposomes, in situ gels, microspheres, emulsions, and nanoparticles. The article concludes by emphasizing the broad application prospects of brain-targeted nasal drug delivery in treating CNS diseases, while acknowledging the limitations and future research directions.