Abstract: The complex environment of the karst area and the hidden location of the caverns bring great challenges to the construction and design of pile foundations.It is crucial to ensure the safety of the superstructure by fully considering the interaction between cavern and pile foundation.The bearing performance of pile foundations in karst areas is taken as the background, and the methods of modeling experiments, numerical simulation and theoretical calculations are highlighted and reviewed.The conclusions show that the present study of the downward-facing karst-type pile foundation focuses on the safe thickness of the top plate, the quality of the rock slab, the diameter of the pile body, and the size of the karst hole.Calculating the relative safety thickness of the top slab is still a difficult problem. For pile foundations penetrating through caverns, it is necessary to solve the construction problems such as slurry leakage and jammed drilling in the construction of cast-in-place piles and prefabricated pile foundations generally have insufficient bearing capacity in karst areas for its small pile diameters and difficult rock embedding. The results provide important guidance for the calculation of vertical bearing capacity of pile foundations in karst cave development areas.