Endoscopic sphenopalatine artery ligation is effective and safe for the treatment of posterior epistaxis for patients who do not respond to conservative treatment. This article reviews the occurrence,development, anatomical analysis, surgical procedure, indications, effectiveness and complications of sphenopalatine artery ligation, etc. The purpose is to understand the theoretical basis of anatomical analysis and clinical significance of electrocoagulation of sphenopalatine arteries for refractory epistaxis. The electrocoagulation of the sphenopalatine artery for the treatment of refractory epistaxis has sufficient theoretical support, clear anatomical landmarks, simple clinical operation and reliable effect. It can be widely used and popularized in clinic.