Myopia is currently one of the eye diseases that seriously threaten patients' vision worldwide, and its occurrence and development is a complex mechanism. It has been found that retinal pigment epithelium(RPE)cells play a key role in the progression of myopia. RPE cells mainly regulate cell function by regulating the expression of intracellular growth factor and matrix metalloproteinase-2(MMP-2)through the signal pathway of mammalian target of rapamycin(mTOR). At the same time, RPE cells can also be regulated by dopamine receptor agonists, so that cell function changes. When dopamine receptor activation weakened, RPE cell function will be impaired, thus promoting the development of myopia. Studies have shown that the expression of acetylcholine and all-trans retinoic acid in RPE cells can regulate the secretion of growth factors by RPE cells, and the growth factors act on scleral fibroblasts, thus indirectly regulating the course of myopia. Additionally, some studies have shown that RPE cells can coordinate the regulation of γ-aminobutyric acid on scleral cells and indirectly regulate the course of myopia. Besides, the expression of microRNA(microRNA)in RPE cells, such as microRNA-328 and microRNA-29a, was found through previous studies that they can affect the content and composition of extracellular matrix by regulating the expression of MMP-2 in RPE cells, thus leading to the occurrence and development of myopia. Therefore, the expression of multiple signaling pathways and miRNA in RPE cells are closely related to the occurrence and development of myopia. This article reviews the research progress of the molecular mechanism of RPE in the development of myopia, with a view to provide some theoretical basis for the specific molecular mechanism in the development of myopia.