Dry eye is a multi-factorial disease characterized by reduced tear film stability and ocular surface damage, accompanied by tear hyperosmolarity and ocular surface inflammation.Recent studies suggest that the disruption of protective immune regulation of the ocular surface and imbalance of inflammatory response play a key role in the pathogenesis of dry eye.Immune-mediated inflammation in dry eye has become a hot topic in recent years.Inflammation and dry eye can cause and promote each other, and eventually form a vicious inflammatory cycle, which can result in a constant damage to the normal structure and function of the ocular surface.Suppressing the ocular surface inflammation and breaking the vicious inflammatory cycle are key points in dry eye treatment.This article summarized the immune regulation of ocular surface, and reviewed the recent research progress of immune-mediated inflammation in the pathogenesis of dry eye, including the activation of natural killer cells, the activation of Toll-like receptors, the secretion of pro-inflammatory cytokines and chemokines, the activation and maturation of corneal antigen presenting cells, the immune inflammatory response mediated by T cells, etc.This article listed the crucial parts and vital mechanisms of immune-mediated inflammation in dry eye to provide potential therapeutic targets for alleviating the ocular surface damages and discomforts caused by dry eye.