Abstract： Syncope is a clinical symptom characterized by an inability to maintain posture due to transient cerebral hypoperfusion. According to the 2018 European Society of Cardiology guidelines，syncope is divided into four types，among which vasovagal syncope（VVS）is the most common cause of syncope in children and adolescents. Children with VVS may experience symptoms such as dizziness，nausea，chest discomfort，and loss of consciousness. Recurrent syncope poses significant distress to the physical and mental health and quality of life of children. Some affected children display symptoms of anxiety and depression，making it crucial to understand the pathogenesis of VVS. In past research，some progress has been made in the pathophysiology of VVS，mainly involving the Bezold-Jarisch reflex，autonomic nervous dysfunction，fluid regulation imbalance，endothelial system disorders，and genetic disorder. This review aims to provide a comprehensive summary of the pathogenesis of VVS，facilitating clinicians in the diagnosis and treatment of children with syncope of unknown cause.