Abstract: Breast cancer-related lymphedema (BCRL) is a common and severe complication of axillary lymph node dissection, with its pathogenesis closely linked to the disruption of axillary lymphatic drainage. This article systematically reviews the preventive strategies for BCRL (de-escalation of axillary surgery, non-surgical interventions, and prophylactic microsurgical techniques), along with treatment modalities (non-surgical complex decongestive therapy, lymphatic reconstruction surgery, and debulking procedures). Current clinical controversies and future research directions have also been discussed, by integrating the latest evidence-based medical data, to provide a reference for standardized BCRL management.