Bipolar disorder（ BD） is a severe mental disorder characterized primarily by recurrent mood swings， with a prolonged course and high recurrence rate. Epidemiological evidence indicates that individuals with BD have a significantly higher risk of developing physical diseases compared to the general population. These comorbidities exhibit a multisystem clustering pattern and exert a substantial impact on functional outcomes and mortality risk. The comorbidity relationship between BD and physical diseases is relatively complex， and its mechanisms may involve pathological and physiological changes in BD patients， adverse drug reactions， shared biological mechanisms， or unhealthy lifestyles. Accordingly， this paper reviews the epidemiological characteristics and potential mechanisms of BD and common physical disease comorbidities， analyzes the management difficulties posed by comorbidity in diagnostic identification， medication selection， treatment adherence， and medical collaboration， and proposes clinical response strategies centered on early risk stratification， regular physical monitoring， and multidisciplinary integrated care， aiming to provide references for improving the long-term outcome of BD patients.