Abstract： The macular hard exudates(HEs)are one of the key factors resulting in poor vision prognosis in pa-tients with diabetic retinopathy(DR).Recently,intraocular injection of anti-vascular endothelial growth factor(anti-VEGF)remains an effective treatment for diabetic macular edema(DME).However,HEs in the macular region showed a dynamic change,and even accumulated in the fovea as the edema resolved.With the development and update of retinal im-aging technology,we can observe HEs more intuitively,which deepens our understanding of their origin,distribution and regression.This review mainly describes the general morphological characteristics,the origin and regression of HEs in DME,and also describes the current treatments to eliminate HEs,so as to provide the reference and basis for the early di-agnosis,treatment and prognosis in DME patients with HEs,and also to provide the basis for the development of drugs or other treatments for HEs regression.