Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease characterized by intense pruritus. A satisfactory understanding of itch in AD has been proved difficult to reach and the relapsing itch is believed to be primarily a result of dysfunction of the skin barrier, dysregulation of the immune system and multiple environmental factors. Itch-scratch cycle exacerbates skin lesions, promotes inflammation and neurological disorders, and triggers the desire to continue scratching. The current methods of treatment for controlling AD pruritus symptoms include topical and systemic drugs. The exploration on the mechanisms of atopic pruritus has provided novel therapeutic targets, such as IL-4, IL-13, IL-31, JAK, IL-33. The new advances in the mechanism and treatment of itch in AD were systemically reviewed.