Cytomegalovirus (CMV) pneumonia is one of the common complications of hematopoietic stem cell transplantation, and is also a significant cause leading to patient death. Due to the poor prognosis of CMV pneumonia, intervention measures are necessary to prevent CMV reactivation and progress to CMV pneumonia. At present, clinical medication mainly relies on preemptive treatment strategies, and the timing of medication depends on the timeliness of early diagnosis. However, feasible methodology and measures for the early diagnosis of CMV pneumonia in clinical practice are relatively limited. Meanwhile the diagnostic gold standard operation is invasive, causing trauma to a certain degree, and the detection timeliness is poor. This review summarizes the clinical status and advances in the diagnosis and drug prophylactic treatment of CMV pneumonia after hematopoietic stem cell transplantation, and explores possible development directions and trends in the future.