The thoracic duct is an important anatomical structure of the abdomen, chest and neck. An accurate understanding of the anatomy of the thoracic duct is critical to ensuring the safety and accuracy of the surgical procedure involving these areas, which can help surgeons reduce accidental injuries and provide more accurate diagnosis and intervention for patients with serious complications such as chylothorax, etc. In addition, it has great reference value to know the anatomy of thoracic duct in advance for the selection of treatment strategies in the treatment of refractory pleural effusion and ascites, chylothorax, and heart failure. Therefore, it is of practical value to be able to perform in vivo lymphangiography before surgery. However, the slender thoracic duct, the hidden position and the complicated anatomical structure variations pose a great challenge to the safety and accuracy of the surgical operation. This paper aims at a comprehensive discussion about anatomic variation of thoracic duct and the development of imaging techniques.