Abstract: Klebsiella pneumoniae, as a clinically prevalent opportunistic pathogen, ranks as the second most commonly detected pathogen in clinical isolates in China.The extensive clinical use of carbapenem antibiotics has led to a high global detection rate of carbapenem-resistant K. pneumoniae (CRKP). Characterized by complex resistance mechanisms and diverse evolutionary pathways, CRKP infections pose significant challenges in prevention and treatment, with high associated mortality rates, creating substantial obstacles for clinical anti-infective therapy.In recent years, the emergence and global spread of carbapenem-resistant hypervirulent K.pneumoniae (CR-hvKP) have escalated into a major public health threat.Notably, hypervirulent K.pneumoniae isolates carrying carbapenem resistance genes are rapidly disseminating worldwide, causing fatal infections even in immunocompetent individuals.This article systematically reviews the latest research advances on the resistance mechanisms, evolutionary pathways, adaptive changes, and clinical management strategies of CR-hvKP, aiming to deepen understanding of this "superbug" and provide a theoretical foundation for clinical prevention and control.