The central amygdala（ CeA） plays a key role in the pathophysiological mechanisms of chronic pain comorbid with anxiety and depression. Numerous studies have shown that patients with chronic pain often suffer from emotional disorders such as anxiety and depression， forming a mutually reinforcing vicious cycle. As the main output nucleus of the amygdala， the CeA plays an important role in emotional regulation and is closely related to the generation and persistence of various negative emotions. Notably， the CeA can also regulate the balance of the intestinal microbiota through the vagus nerve pathway. Chronic stress-induced suppression of CeA activity leads to a significant reduction in the number of intestinal lactobacilli， thereby impairing immune function. This paper systematically elucidates the mechanisms underlying the role of the CeA in the onset and progression of chronic pain comorbid with anxiety and depression from multiple perspectives， including neuronal functional characteristics， neural circuit connections， and gut-brain axis regulation， providing important theoretical basis for the development of innovative treatment strategies.