In 1985, Shiseido in Japan first reported the use of microbial culture to prepare hyaluronic acid. Since the 1970s, hyaluronic acid has been used as an adjuvant in ophthalmic surgery, and subsequently, because of its properties such as inhibition of cellular activity, stimulation of macrophages, and inhibition of inflammation, it has been extended to orthopedic treatment. In recent years, it has been widely used in the field of cosmetic injections because of its non-immunogenic, degradable and absorbable properties. Hyaluronic acid is a high molecular non-protein acidic mucopolysaccharide widely present in the human body, and about half of the hyaluronic acid in the human body is found in the skin. It is highly hydrophilic and water-retentive, absorbing 1000 times its weight in water. Hyaluronic acid, together with other mucopolysaccharides, collagen and elastin, form a water-rich extracellular gelatinous matrix, which makes the skin more hydrated and elastic. The extraction methods of hyaluronic acid can be divided into animal tissue extraction and microbial fermentation extraction, while animal tissue extraction is less pure, more expensive and less efficient. It is mainly extracted from animal tissues and organs, with organic solvents to remove proteins, and then purified after soaking, filtration and precipitation procedures. However, due to the limited resources of animal organs and tissues, the extraction and separation process is more complicated, therefore, it is not possible to form a large-scale production. The most important point is that the molecular weight of hyaluronic acid extracted by this method is relatively small. The microbial fermentation method can effectively compensate for these shortcomings. It uses glucose as the carbon source, ferments the streptococci in the medium, washes and extracts them in acetone dehydration distilled water, filters out the mycelium, removes the protein, and finally performs complexation, dissociation, precipitation and drying procedures to refine them. Moreover, the rate of allergic and inflammatory reactions is low, and the injection effect is maintained for a long time. At present, this method is mainly used in the large-scale production.