Thyroid-associated ophthalmopathy(TAO)represents the most prevalent chronic orbital disease in adults, significantly compromising patients' quality of life and physical and psychological well-being. Orbital decompression surgery has now emerged as a critical therapeutic intervention for reducing proptosis and alleviating optic nerve compression in TAO patients, with the development of tailored surgical regimens reflecting a key trend. Nonetheless, ophthalmologists encounter persistent hurdles in navigating the selection of optimal surgical techniques and quantifying the necessary extent of decompression. This review systematically synthesizes recent research advances in orbital decompression surgery for TAO. It examines the efficacy, indications, and key technical considerations of various surgical techniques, including orbital fat decompression, orbital wall decompression, and multi-wall decompression. Furthermore, the review summarizes critical factors influencing surgical outcomes and the application of various emerging techniques in orbital decompression procedures. This study aims to enhance the understanding of orbital decompression surgery and provide novel perspectives for ophthalmologists in formulating personalized surgical decompression strategies.