PurposeThe purpose of this paper is to illustrate the new technical demands and reliability challenges to printed circuit board (PCB) designs, materials and processes when the transmission frequency increases from Sub-6 GHz in previous generations to millimeter (mm) wave in fifth-generation (5G) communication technology.Design/methodology/approachThe approach involves theoretical analysis and actual case study by various characterization techniques, such as a stereo microscope, metallographic microscope, scanning electron microscope, energy dispersive spectroscopy, focused ion beam, high-frequency structure simulator, stripline resonator and mechanical test.FindingsTo meet PCB signal integrity demands in mm-wave frequency bands, the improving proposals on copper profile, resin system, reinforcement fabric, filler, electromagnetic interference-reducing design, transmission line as well as via layout, surface treatment, drilling, desmear, laminating and electroplating were discussed. And the failure causes and effects of typical reliability issues, including complex permittivity fluctuation at different frequencies or environments, weakening of peel strength, conductive anodic filament, crack on microvias, the effect of solder joint void on signal transmission performance and soldering anomalies at ball grid array location on high-speed PCBs, were demonstrated.Originality/valueThe PCB reliability problem is the leading factor to cause failures of PCB assemblies concluded from statistical results on the failure cases sent to our laboratory. The PCB reliability level is very essential to guarantee the reliability of the entire equipment. In this paper, the summarized technical demands and reliability issues that are rarely reported in existing articles were discussed systematically with new perspectives, which will be very critical to identify potential reliability risks for PCB in 5G mm-wave applications and implement targeted improvements.