〔Abstract〕 Intraoperative cell salvage (IOCS) is an important way of blood preservation in clinic. Because perioperative bleeding is an important factor affecting the process of operation, recovery, and even endangering the life of patients, it has been widely used in spinal surgery with great blood demand. The author this article reviews the indications and contraindications, application status, blood quality, economic benefits and existing problems (application of spinal tumor surgery, leukocyte contamination) of IOCS in spinal surgery. At present, a large number of studies have shown that IOCS can reduce the demand for allogeneic blood transfusion in patients with spine, reduce the related risks and costs. If used properly, autologous rescue blood may have higher quality than allogeneic blood, reduce the probability of postoperative complications and accelerate postoperative rehabilitation, which is in line with the concept of accelerated rehabilitation. However, there are still some problems in practical application, such as leukocyte filtration, bacterial contamination or spinal tumor surgery, which are worthy of in-depth research and exploration.