【】: The blood-brain barrier (BBB) is a dynamic interface for selective molecular trafficking between blood and brain parenchyma, playing a pivotal role in maintaining central nervous system (CNS) homeostasis. Recent investigations have uncovered intricate regulatory networks governing BBB function, involving dynamic [1]remodeling of intercellular tight junctions, activation of signaling cascades, and multicomponent interactions within the neurovascular unit.This review systematically synthesizes current mechanistic insights into BBB regulation.Moreover, it also focuses on pathological remodeling observed in various neurological diseases. Emerging interventional strategies, including nanotechnology-based drug delivery systems, gene editing, and traditional Chinese medicine (TCM) formula interventions, are critically evaluated with emphasis on their translational potential. By integrating bench-to-bedside perspectives, this work aims to provide novel theoretical frameworks for developing precision therapies targeting BBB dysfunction in neurological disorders.