<p>Degenerative Spinal Deformity, as a severe form of spinal degeneration, has become a major public health issue affecting the health and quality of life of middle-aged and elderly populations. Its disease burden is increasing year by year, yet clinical attention to the identification and intervention of early risk factors remains insufficient. Combining the latest epidemiological data, pathological mechanism research, and clinical evidence, this review systematically summarizes the key risk factors for Degenerative Spinal Deformity from a four-category system: non-modifiable risk factors, modifiable exposure factors, comorbidities/drugs, and structural/functional mediating factors. It analyzes the interactions between these factors, clarifies research limitations, and proposes future directions. The aim is to provide an evidence-based basis for the early screening, risk stratification, and individualized prevention of Degenerative Spinal Deformity, as well as potential intervention targets to reduce the disease incidence and surgical rate (which require verification by prospective studies).</p>