Background Thoracic paravertebral blockade(TPVB) is a regional nerve blocking technique by injecting local anesthetics into thoracic paravertebral space, adjacent to the intervertebral foramina, to block the roots of thoracic nerves. This technique can be performed under the guidance of anatomical markers or ultrasound, and has been widely applied in thoracic and abdominal surgeries for postoperative pain management. Objective To summarize anatomical basis and clinical application of TPVB. Content The injection sites of TPVB are located near thoracic paravertebral space(TPVS), which can be identified with traditional and ultrasound-assisted methods. The local anesthetics including bupivacaine, lidocaine, and ropivacaine, were administered with TPVB to relieve pain in one-sided thoracic and abdominal surgeries and chronic pain syndromes, and also to perform anesthesia in breast surgery. With satisfying analgesic and anesthetic effects, TPVB has less adverse effects than epidural and intravertebral anesthesia, and interpleural blockade. Trend TPVB under the guidance of ultrasound provides a safe drug injection technique for multimodal analgesia with similar efficacy to epidural and intravertebral injection, but less adverse effects. Further investigations are required to expand its application and to prevent related complications. Key words: Thoracic paravertebral block; Regional anesthesia; Technique pharmacokinetics; Complication