Drowning is an accidental injury factor with high disability and death rates. The disease progresses rapidly, and the victims are often in a critical condition. Moreover, due to the complex pathophysiological mechanism, the current treatment is very limited. As a special type of drowning, cold water immersion syndrome usually occurs immediately after the patient is immersed in cold water and runs through the whole process of drowning. It often leads to cardiac arrest and other critical situations, playing an important role in the occurrence and development of drowning. This article focuses on the pathophysiological mechanism of cold water immersion syndrome and summarizes its clinical diagnosis and treatment, so as to provide a theoretical basis for further clinical treatment.