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 homeostasis. Recent investigations have uncovered intricate regulatory networks governing BBB function, involving dynamic intercellular tight junction remodeling, signaling cascade activation, and multicomponent interactions within the neurovascular unit. This review systematically integrates current mechanistic understanding of BBB regulation and provides a critical evaluation of emerging interventional strategies, including nanotechnology-based drug delivery systems, gene editing,and traditional Chinese medicine formula interventions, with emphasis on their translational potential in the future. By integrating bench-to-bedside perspectives, this work aims to provide novel theoretical frameworks for developing precision therapies targeting BBB dysfunction in neurological disorders.