Intracranial arterial dolichoectasia (IADE) is a major artery disease characterized by arterial elongation, dilatation and curvature,the pathological mechanism of IADE is not very clear. Recent studies have shown that matrix metalloproteinases (MMPs) are closely related to the pathogenesis of IADE. Therefore, the author summarized the possible pathological mechanism of MMPs induced IADE from four aspects: MMPs activation and IADE occurrence and development, the correlation between MMPs activation and positive remodeling, hemodynamic changes, and the relationship between MMPs activation and IADE, and the relationship between clinical associated diseases with IADE and MMPs,providing more possible therapeutic targets for effective prevention and treatment of IADE.