Patulin, a toxic secondary metabolite of fungi, exists widely and stably in fruits, vegetables, grains, nuts and Chinese medicinal materials. Patulin enters the body through skin contact or food intake, posing a great threat to the health of humans and animals. Previous studies have shown that patulin can induce genotoxicity, immunotoxicity and reproductive toxicity, damaging the intestine, kidney, liver and other organs in the body. The toxic mechanism of patulin involves inducing damage to biological macromolecular structures, oxidative stress injury and cell autophagy as well as damaging intestinal flora homeostasis. In this article, the recent status of patulin contamination in foods is reviewed, with an emphasis on the latest progress in research on the toxicity and mechanism of action of patulin. It is hoped that this review will provide a theoretical basis for patulin detoxification.