Abstract: Third- generation aromatase inhibitors (AIs) have been considered as standard adjuvant endocrine therapy for hor-mone- responsive breast cancer in postmenopausal women. Aromatase inhibitor- associated musculoskeletal symptoms (AIMSS) are prevalent among patients undergoing AI therapy; these symptoms result in reduced quality of life and poor dependence to AI treatment. The mechanisms mediating AIMSS and the effective management of AIMSS have not been extensively investigated. This article re-views the incidence, clinical characteristics, possible mechanisms, and treatment of AIMSS.