Dry eye is a multifactorial disease of tear film and ocular surface that results in discomfort, visual disturbance and tear film instability. Many factors contribute to dry eye which cause pathophysiological changes of the ocular surface.Whatever the clinical situation of dry eye is different, the diseases show the similar pathophysiological progress. Inflammation is the key mechanism and the other factors such as apoptosis ,hormonal regulation are involved in dry eye pathogenesis. The main approach to the treatment of dry eye is providing lubricating eye drops or tear substitute. The newer treatment approach is to target the underlying cause of dry eye instead of conventional symptomatic relief. Although recent research has made progress in elucidating dry eye pathophysiology, pathogenesis and treatment, there are no uniform diagnostic criteria. This paper presents a review about the pathophysiology, etiopathogenesis and treatment of the dry eye.