With the rapid development and widespread application of optical coherence tomography(OCT), peripapillary hyper-reflective ovoid mass-like structure (PHOMS) has become one of the common signs of OCT in neuro-ophthalmic clinical practice. Whether this structure is physiological or pathological has not been determined, and it is speculated that it may be related to the stagnation of the axial plasma of the optic papilla. In this review, we describe the morphological characteristics of PHOMS, summarize various diseases related to PHOMS, and proposes some doubtful points and research directions for PHOMS, aiming to provide evidence for clinicians to identify PHOMS as early as possible and treat fundus diseases in the early stage.