Abstract: Respiratory syncytial virus (RSV) infection remains a leading cause of respiratory illness in infants and young children worldwide, with no widely available specific treatment. Advances in diagnostic technologies have increased the detection rate of RSV co-infections, but their impact on disease outcomes remains controversial. This work examines the epidemiological characteristics, clinical implications, and potential mechanisms of RSV co-infections. Findings indicate that RSV co-infections with bacteria or adenoviruses lead to more severe clinical symptoms and more complex treatment, while co-infections with other viruses may prolong illness without increasing severity. The specific mechanisms underlying RSV co-infections are still poorly understood. In recent years, significant breakthroughs in RSV vaccine and long-acting monoclonal antibody development have provided new tools for active prevention. Future research should focus on clarifying the molecular mechanisms of co-infections, developing targeted therapeutic drugs and vaccines, and optimizing diagnostic and treatment strategies to reduce the incidence and mortality of RSV-related diseases.