Autophagy-lysosomal pathway (ALP) is the degradation system that remove unfolded proteins and damaged organelles in cells, and plays an important role in maintaining intracellular homeostasis.The process of autophagy mainly includes autophagosome formation, autophagosome-lysosome fusion, and degradation of cargoes in mature lysosomes by lysosomal enzymes.Dry eye disease, meibomian gland dysfunction and keratopathy are common ocular surface diseases associated with diabetes mellitus, and clinical manifestations include dry eyes, reduced tear secretion, persistent corneal epithelial defects, neuropathy (decreased corneal sensitivity) and endothelial cell dysfunction.Aberrant expression of gene, oxidative stress and inflammation related advanced glycosylation end products and reactive oxygen species are significant pathogenesis of ocular surface diseases related to diabetes.Moreover, the above pathogenesis involves defects of autophagy regulatory gene, abnormal expression of autophagy related protein and activation of autophagy signaling pathway which lead to the defects of ALP such as autophagosome lysosome fusion disorder, accumulation of cargoes and abnormal lysosomal function, and the deficiency of autophagy further promoting the oxidative stress and release of inflammatory factors.The occurrence and development of ocular surface diseases associated with diabetes are closely related to the defects of ALP.This article reviews the basic research status between the defects of ALP and diabetic ocular surface diseases to provide new ideas for the mechanism and treatment research.