Obstructive sleep apnea hypoventilation syndrome (OSAS), commonly known as “snoring”, has a high prevalence in the population and can involve multiple target organs throughout the body, potentially causing a range of systemic complications due to collapse of the upper airway at night. Currently, the mainstream treatments for OSAS include long-term nocturnal ventilator wear or surgical intervention. So, does the treatment of OSAHS require surgery? How to select patients with expected surgical outcome for surgery are all frequently confused by otolaryngologists. Accurate assessment of the obstruction plane and a multiplanar surgical strategy are prerequisites for a good surgical outcome in OSAS patients. The most common procedure used in sleep surgery is uvulopalatopharyngoplasty (UPPP), as it only targets the oropharyngeal obstruction plane and is only about 40% effective. However, if the upper airway obstruction planes can be accurately evaluated preoperatively, combined with multi-planar surgery to relieve multi-planar obstruction, the efficacy of OSAHS treatment can be significantly improved, and the long-term surgical efficiency can reach about 70%. Therefore, the field of OSAS surgery advocates an individualized multiplanar surgical strategy based on the plane of obstruction, thus enabling patients to achieve long-term, optimal therapeutic benefit. Induced sleep endoscopy is a fundamental test to predict surgical outcomes and to perform multiplanar surgery. In several foreign sleep centers, it has become a mandatory preoperative examination for OSAS patients. Due to technical limitations, many units in China are not yet able to perform this examination, which somehow leads to less than optimal surgical outcomes. In conclusion, the surgical outcome of OSAS patients varies from person to person and should be accurately evaluated by an experienced otolaryngologist before choosing between surgery or long-term ventilator use.