Abstract: In China breast cancer is one of the common cancers for female, which seriously threatens people's health and life. Seventy to eighty percent of breast cancers are estrogen receptor (ER)-positive tumors. Endocrine therapy is the main strategy for ER-positive breast cancer. Novel endocrine drugs, which have brought hopes to improve the therapeutic effect and prolong the overall survival of patients, have been created and used for patients with ER-positive breast cancer in the recent decades. However, the resistance to endocrine therapy has gradually emerged to be a severe problem. In order to provide new ideas targeting endocrine resistance for early prediction and treatment of ER-positive breast cancer, we combined the current theory and mechanism of endocrine resistance, as well as the latest published research results in this review.