Upper airway cough syndrome, also known as postnasal drip syndrome, is a syndrome in which secretions flow backwards into the postnasal and pharyngeal regions, or even into the vocal cords or trachea, due to nasal disease, resulting in a cough as the main manifestation. Upper airway cough syndrome is one of the common causes of chronic cough, accounting for 41% of patients with chronic cough and constituting one of the three main causes of chronic cough along with asthma and gastro-oesophageal reflux disease. There are no specific clinical manifestations of upper airway cough syndrome. In addition to cough symptoms, patients usually report a dripping sensation in the throat, adherence of oropharyngeal mucus, frequent throat clearing, pharyngeal discomfort or nasal itching, nasal congestion, runny nose, and sneezing. Sometimes patients may complain of hoarseness, and even speech may trigger coughing. Some of them may have no obvious nasal symptoms and only present with paroxysmal cough, while they are easily misdiagnosed as chronic bronchitis, cough variant asthma, etc. after long term treatment without significant improvement, causing great pain to the patients. The underlying diseases causing upper airway cough syndrome include allergic rhinitis, perennial non-allergic rhinitis, post-infectious rhinitis, bacterial sinusitis, allergic fungal sinusitis, rhinitis due to anatomical abnormalities, rhinitis due to physical and chemical irritation, occupational rhinitis, drug rhinitis, and rhinitis of pregnancy. Those with large amounts of sputum are mostly due to chronic sinusitis. Vasodilatory rhinitis is characterized by large amounts of thin, watery nasal secretions sometimes produced in response to changes in temperature. In patients with chronic cough, upper airway cough syndrome should be highly suspected if there are no obvious auscultatory signs in the lungs and no obvious abnormalities on chest X-ray. CT scan of the sinuses reveals manifestations of chronic sinusitis, such as thickened nasal mucosa, indistinct nasal cavity, and mucus in the sinuses, which are useful in confirming the diagnosis. Endoscopic examination of the nasopharynx reveals redness and congestion of the nasal mucosa, mucus adherence, and redness and congestion of the nasopharynx, all of which are helpful in the diagnosis. If the cough is seasonal or if the history suggests exposure to specific allergens (e.g., pollen, dust mites, etc.), an allergen test may be helpful. Aspergillus and other fungal skin tests may be performed when allergic fungal sinusitis is suspected. The diagnosis of upper airway cough syndrome is based on the diagnostic criteria recommended in our Guidelines for the Diagnosis and Treatment of Cough: 1. Episodic or persistent cough, mainly in the standing position during the day and less frequently after sleep. 2. Postnasal drip or a feeling of mucus adherence to the posterior pharyngeal wall. 3.History of rhinitis, sinusitis, nasal polyps or chronic pharyngitis. 4.Examination reveals mucus attachment to the posterior pharyngeal wall with a cobblestone-like appearance. 5.Cough relief after targeted treatment. Treatment of upper airway cough syndrome is mainly directed at the treatment of the underlying disease. For chronic cough caused by inflammatory diseases of the nasal cavity and sinuses, the principles of treatment are anti-infection, opening the sinus opening, promoting drainage, and reducing inflammation; drugs to reduce nasal mucosal congestion such as ephedrine can reduce nasal congestion, and nasal glucocorticoids can significantly reduce nasal inflammation. Patients with positive skin test should avoid contact with allergens as much as possible, and desensitization therapy is feasible if necessary. If conservative treatment is not effective and surgery is indicated, functional nasal endoscopic surgery such as nasal polypectomy and sinus opening is feasible. The key to prevention of upper airway cough syndrome is to prevent nasal inflammation in two ways. The first is to actively prevent and treat upper respiratory tract infections; the second is to avoid exposure to allergens as much as possible. Improving the environment and avoiding allergen stimulation are effective measures to control allergic rhinitis. For suspected and confirmed upper airway cough syndrome, symptomatic management should be enhanced on the basis of allopathic treatment. In summary, upper airway cough syndrome is easily missed and misdiagnosed clinically, mainly because of the lack of knowledge of the disease, and because only the tonsils, throat, and lung manifestations are noted, and the diagnosis of interstitial pneumonia is made when the chest radiograph shows texture thickening, while the patient’s history and other signs are ignored. In fact, upper airway cough syndrome is one of the most important causes of chronic cough, and it should be considered first in patients with chronic cough.