Synaptic pruning, as a core process in neural development and functional maintenance in the mammalian central nervous, relies on precise molecular and cellular regulation and is crucial for constructing efficient and stable neural networks. Dysregulation of synaptic-pruning mechanisms disrupts the dynamic equilibrium of neural connections, closely associated with the onset and progression of various central nervous system diseases. The mechanisms underlying glial cell-mediated synaptic elimination are not yet fully understood; however, multiple signals promoting or inhibiting synaptic clearance are known to be involved in collectively regulating this complex process. Indepth analysis of the cellular and molecular mechanisms governing synaptic formation and elimination can not only reveal the underlying pathogenesis of central nervous system diseases, but may also provide a theoretical basis for their early diagnosis and intervention, and for the development of innovative therapies. Further exploration of synapticpruning mechanisms has the potential to result in critical breakthroughs in tackling neurological disorders.