Abstract: Melioidosis is a potentially fatal zoonotic disease caused by Burkholderia pseudomallei, which possesses multiple virulence factors, including capsule, lipopolysaccharide, type Ⅲ secretion system, etc., to invade various organs and systems, cause diverse clinical manifestations such as pneumonia, abscesses and meningitis, and pose challenges for diagnosis and treatment. B. pseudomallei is intrinsically resistant to many conventional antibiotics, and its resistance mechanisms are complex, involving efflux pumps, enzyme inactivation, target alteration, and biofilm formation, etc.. Current therapeutic regimens mainly include intravenous intensive therapy with ceftazidime or carbapenems, followed by oral eradication therapy with compound sulfamethoxazole. However, poor therapeutic effects are still common. Extending the course, increasing dosage, combined therapy and actively managing of local lesions are the main strategies at present. Moreover, novel antibiotics, efflux pump inhibitors and phages may become new options. Strengthening the basic and clinical research in this field and developing new diagnostic and therapeutic methods are of great significance for improving the prognosis of melioidosis.