The hypothalamus is a vital neuroendocrine center in the human body， playing a crucial regulatory role in the autonomic nervous system and endocrine system. Surgery for tumors in the hypothalamic region remains one of the most challenging neurosurgical procedures to date. Surgical damage to the hypothalamus often leads to hypopituitarism， water-electrolyte imbalances， hypothalamic obesity， thermoregulatory disorder， abnormal sleep rhythms， and emotional disturbances. Autonomic nervous system dysfunction plays a significant role in the pathogenesis of the aforementioned complications. Heart rate variability， urinary catecholamine metabolites， and microneurography are currently the most commonly used methods for assessing autonomic nervous system activity. Currently， evidence indicates that patients with hypothalamic injury exhibit autonomic nervous dysfunction， but there is no consensus on the specific type of dysfunction. Modulation of autonomic nervous system activity holds promise as a novel therapeutic target for patients with hypothalamic injury， and accurate assessment of autonomic nervous function represents a crucial step in developing treatment plans for these patients.