<p>Organ adhesions pose a significant clinical challenge, arising from factors such as congenital adhesions caused by embryonic developmental abnormalities, as well as acquired adhesions resulting from inflammation or surgery. This phenomenon commonly occurs in conditions such as peritonitis, pelvic inflammatory disease, and malignant tumor infiltration. Postoperative adhesions might cause serious complications such as chronic pain, infertility and intestinal obstruction. Traditional treatment methods (anti-adhesion membranes and drug therapy), have some limitations, including insufficient mechanical properties, poor biocompatibility or difficulty in achieving full intervention. As a novel generation of biomaterials, hydrogels demonstrate significant advantages in preventing and treating organ adhesions: physical barriers, biocompatibility, multidimensional functional integration, controlled drug release, dynamic adaptation to complex environments, and intelligent responsiveness. This review aims to systematically summarize research progress on hydrogels in organ adhesion prevention and treatment, integrating their mechanisms of action across different pathological stages, material innovations, and organ application cases. This study provides strategies to overcome clinical translation bottlenecks and outlines future research directions.</p> Graphical abstract <p></p>