Graves ophthalmopathy(GO) is an extrathyroidal manifestation of Graves' disease, mainly a complex autoimmune disease mediated by cellular immunity. Orbital fibroblasts and adipocytes are target cells for immune response, while Thyroid stimulating hormone receptor and insulin-like growth factor-1 are key autoantigens. In addition to smoking, post radiation iodine therapy, and other risk factors, hypercholesterolemia has been identified as a new risk factor for GO. Corticosteroids have an unshakable position in the treatment of moderate to severe active GO, but some patients do not respond after treatment or experience recurrence. It is necessary to seek new drugs. Bio-targeted agents, cytokine inhibitors, and statins with anti-inflammatory effects have gradually been studied and applied in the clinical treatment of GO. This review mainly introduces the main pathogenesis of GO and the new progress in drug therapy for moderate to severe active GO.