Abstract: Metastatic cancer-induced bone pain is the most common pain complaint in patients with advanced cancer. Cancer-induced bone pain can significantly affect patients' quality of life and worsen their prognosis. This bone pain includes different types, such as background pain and breakthrough pain, and its underlying molecular mechanism is complex, including inflammatory pain and neuropathic pain, which may change with tumor progression. Current clinical treatments mainly comprise drug therapies, such as peripheral and central analgesics and osteoclast blocking, and non-drug therapies, such as radiotherapy, nerve damage, and neuromodulation. Thus, elucidating the molecular mechanism underlying bone cancer-induced pain is crucial for its optimal treatment. This study aims to review advances in the current understanding of the molecular mechanism and clinical treatment of metastatic cancer-induced bone pain.