Primary retroperitoneal tumor has brought great challenges to clinical diagnosis and treatment because of its concealed anatomical location, diverse pathological types and complex diagnosis. In recent years, with the development of imaging technology and the progress of surgery, the research in this field has been deepening. However, there are still some problems such as difficulties in early diagnosis, unclear treatment options and high postoperative recurrence rates. This article reviews the latest progress in the pathological types, imaging diagnosis, perioperative management, surgical strategies, prognostic factors and future development of retroperitoneal tumors, focusing on the diagnosis and treatment techniques and strategies from the perspective of surgery. By comprehensively analyzing the biological behavior of tumors and surgical resection technology, this paper discusses the important role of the multidisciplinary cooperation mode in improving the prognosis of patients, aiming to provide a systematic and cutting-edge reference for clinicians, and promote the standardized diagnosis and treatment of retroperitoneal tumors.