Indoleamine 2,3-dioxygenase (IDO) is a key enzyme in the tryptophan metabolism pathway, primarily involved in metabolizing tryptophan into kynurenine. IDO is expressed in immune cells such as dendritic cells, where it inhibits T cell proliferation by depleting tryptophan, contributing to immune evasion and tolerance. IDO1 and IDO2 are the main members of its family, exhibiting specific expressions in different tissues. The activity of IDO is regulated by inflammatory factors, and its expression and functional mutations are associated with health issues such as cancer and autoimmune diseases. Research on the IDO pathway has offered new therapeutic strategies, especially in the field of tumor immunotherapy.